对慢性阻塞性肺部疾病的护理改善计划的捆绑支付的有效性
Amelia Waltman1, R Tamara Konetzka2, Stephanie Chia3
1Pritzker School of Medicine, University of Chicago, Chicago, USA.
Journal of general internal medicine
|June 20, 2023
概括
一个COPD护理改善捆绑支付 (BPCI) 计划显示了非显著的成本节省和减少再录取. 针对复杂患者可能会增加财务影响.
科学领域:
- 卫生经济学 卫生经济学
- 基于价值的医疗保健
- 肺部医学 肺部医学
背景情况:
- 医疗保险 (Medicare) 的护理改善捆绑支付 (BPCI) 计划鼓励在入院后90天的护理期间降低成本.
- 慢性阻塞性肺病 (COPD) 是医院再入院的重要驱动因素,使其成为基于价值的支付改革的关键领域.
研究的目的:
- 评估实施COPD专用BPCI计划的财务影响.
- 评估基于证据的护理转型计划对COPD患者的病例成本和再入院率的影响.
主要方法:
- 一个单一地点的回顾性观察研究.
- 将因COPD恶化而住院的接受干预的患者与没有干预的患者进行比较.
- 分析平均事件成本和90天再入院率.
主要成果:
- 干预组在11个季度中的6个季度中平均事件成本低于目标,而对照组则是12个季度中的1个季度.
- 干预组的整体非显著的平均节省每次节省2551美元,根据诊断相关组 (DRG) 的节省有所不同.
- 对干预组来说,每次病例的回收率平均下降了0.24,并且回收/SNF释放增加了成本.
结论:
- 慢性肺炎 BPCI 计划显示其节约成本效果不显著,可能受到研究功率的限制.
- 针对更复杂的临床患者 (更高的DRG) 的干预措施可能会增加该计划的财务影响.
- 需要进一步的研究来确认BPCI计划是否减少了护理变化和改善了护理质量.
更多相关视频
相关概念视频
01:29Chronic Obstructive Pulmonary Disease-V: Management
2.6K
Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
Smoking Cessation
2.6K
01:30Chronic Obstructive Pulmonary Disease-V: Nursing Management
4.0K
Nursing management of Chronic Obstructive Pulmonary Disease (COPD) is crucial for providing thorough care and support to patients. Nurses play an integral role in this process through detailed assessment, careful planning, targeted interventions, and ongoing evaluation. Here's an overview of the critical steps in nursing management for COPD.
Assessment
Assessment
4.0K
01:22Chronic Obstructive Pulmonary Disease
1.3K
COPD is defined as a heterogeneous lung condition marked by persistent respiratory symptoms such as dyspnea, cough, and sputum production, caused by abnormalities in the airways that cause airflow obstruction.
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
1.3K
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
2.5K
Assessing and diagnosing Chronic Obstructive Pulmonary Disease (COPD) involves a detailed approach that includes a comprehensive review of medical history, physical examination, and a variety of diagnostic tests. This thorough evaluation is essential to ensure an accurate diagnosis and guide effective management strategies.
Medical History
Medical History
2.5K
01:20Chronic Obstructive Pulmonary Disease-I: Introduction
2.8K
Chronic Obstructive Pulmonary Disease (COPD) is a long-lasting respiratory condition requiring continuous attention and care. It is a progressive lung disease that leads to breathing challenges due to airflow obstruction. It manifests as persistent respiratory symptoms and restricted airflow resulting from abnormalities in the airways and alveoli, usually due to long-term exposure to harmful particles or gases. COPD mainly consists of two primary conditions: emphysema and chronic bronchitis.
2.8K
01:26COPD: Management Using Bronchodilators and Corticosteroids
255
Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
255