在中风或过渡性缺血性心脏病发作后被送回家的患者中的后急性支出:综合性后急性中风服务 (COMPASS) 试验
Yucheng Hou1, Karishma D'Souza1, Anna M Kucharska-Newton2
1Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
概括
综合性急性中风后服务 (COMPASS) 过渡性护理干预措施在中风患者退院后的一年内没有显著改变医疗保健支出. 这项研究发现,在不同保险支付人之间,COMPASS模型和通常护理之间没有总体成本差异.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床经济学 临床经济学
- 脑卒中护理管理
背景情况:
- 对于中风幸存者来说,急性后护理过渡非常重要.
- 优化过渡期护理旨在改善结果并管理医疗保健成本.
- 在COMPASS试验中,评估了针对中风患者的特定过渡期护理模式.
研究的目的:
- 估计与常规护理相比,接受COMPASS过渡期护理 (TC) 干预的患者的医疗保健支出差异.
- 分析不同支付者 (医疗保险,医疗补助,私人保险) 的成本.
- 评估COMPASS-TC模型对医疗保健总支出的影响.
主要方法:
- 实用试验涉及北卡罗来纳州40家医院,集群随机化为COMPASS-TC或常规护理.
- 将试验数据与来自医疗保险,医疗补助和私人保险公司的行政索赔联系起来.
- 主要结果:90天的总支出;次要结果:30天和365天的支出. 进行了治疗意图和每协议分析.
主要成果:
- 在COMPASS-TC和常规护理之间90天后的总后急性支出没有统计学上显著的差异,在支付人之间一致.
- 在COMPASS部门的医疗保险受益者显示,90天的住院再入院费用和30天的急诊室和门诊护理费用更高.
- 对医疗保险患者的每条协议分析没有显示90天的支出有显著差异.
结论:
- 对于中风患者来说,COMPASS-TC模型在出院后的一年内没有显著改变医疗保健总支出.
- 虽然特定的费用类别增加了医疗保险受益人,总体支出仍然相当于通常的护理.
- 结果表明,COMPASS过渡期护理模型的实施,在这个务实的试验中没有产生显著的经济效益.
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