整合初级医疗保健与成治疗:一个随机对照试验
C Weisner1, J Mertens, S Parthasarathy
1Kaiser Permanente Division of Research, 3505 Broadway, 12th Floor, Oakland, CA 94611, USA.
JAMA
|October 12, 2001
概括
综合医疗和药物滥用治疗显著改善了与药物滥用相关的医疗状况 (SAMCs) 患者的戒断率. 这种协调护理模式为这个弱势群体提供了具有成本效益的好处.
科学领域:
- 成 药物 药物 药物 药物
- 公共卫生 公共卫生
- 医疗保健管理的管理
背景情况:
- 在药物滥用患者中,同时出现的医学疾病的高患病率.
- 医疗服务在药物滥用治疗计划中的有限整合.
- 在这个人群中,与未经治疗的疾病相关的显著医疗保健费用.
研究的目的:
- 将综合与独立的医疗和药物滥用护理模型的治疗结果和成本进行比较.
- 评估综合护理对药物滥用相关疾病患者 (SAMCs) 的具体影响.
主要方法:
- 随机对照试验涉及592名成年患者参加化学依赖计划.
- 综合护理模式 (成治疗中的初级护理) 与独立护理模式 (单独服务) 的比较.
- 评估戒断率,治疗利用率和6个月后的费用.
主要成果:
- 在综合和独立护理组之间,整体戒断率没有显著差异.
- 患有SAMC的患者在综合治疗组中表现出明显更高的戒断率 (69%对55%,P=.006).
- 对SAMC患者的综合护理表明,每位额外的戒断患者的成本效益比为1581美元.
结论:
- 综合医疗和药物滥用治疗对SAMC患者有益.
- 综合模型可以是一个具有成本效益的方法来管理同时出现的条件.
- 这些发现支持政策变化和新治疗策略,用于药物滥用患者的医疗并发症.
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