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Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
改善血糖控制对医疗保健成本和利用率的影响
E H Wagner1, N Sandhu, K M Newton
1MacColl Institute for Healthcare Innovation, Center for Health Studies, Group Health Cooperative, 1730 Minor Ave, Suite 1290, Seattle, WA 98101, USA. wagner.e@ghc.org
JAMA
|February 15, 2001
概括
通过持续降低血红蛋白A1c (HbA1c) 来改善糖尿病管理,可以在一到两年内大幅节省医疗费用. 这项研究强调了糖尿病患者更好地控制血糖的财务益处.
科学领域:
- 卫生经济学 卫生经济学
- 糖尿病管理 糖尿病管理
- 临床结果 临床结果
背景情况:
- 与糖尿病管理相关的医疗保健成本上升需要了解改善血糖控制的财务影响.
- 有兴趣确定在改善糖尿病护理后降低成本的时间表.
研究的目的:
- 调查糖尿病患者血红蛋白A1c (HbA1c) 水平持续改善是否会导致医疗保健利用率和成本下降.
- 建立血糖控制改善和随后的医疗保健成本节省之间的时间关系.
主要方法:
- 从1992年到1997年,在一个员工模型健康维护组织中进行了一项历史的队列研究.
- 连续注册的糖尿病患者 (n=4744) 被分析;在1992-1994年期间,732名患者实现了持续的1%或更大的HbA1c降低.
- 医疗保健总成本,住院率和门诊访问频率在改善和不改善的队列之间进行了比较.
主要成果:
- 从1994年开始,改进的队列从统计学上显著地节省了每年685-950美元的成本,特别是在基线HbA1c≥10%的队列中.
- 包括初级和专科护理访问在内的医疗保健利用率在1994年开始的改善队列中始终较低.
- 两组之间没有观察到住院率的统计学上显著差异.
结论:
- 成年糖尿病患者中HbA1c水平的持续降低与显著的医疗保健成本节省有关.
- 这些成本节约在改善血糖控制后的1至2年内变得明显.
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