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在退伍军人卫生管理局社区免疫治疗的增长
Megan Ellis Price1, Sarah Gordon1,2, Caroline Emmitt1,2
1VA Boston Medical Center, Boston, Massachusetts, USA.
Cancer medicine
|July 31, 2023
概括
退伍军人健康管理局 (VA) 社区免疫疗法使用量从2015年至2020年急剧增加. 老年,农村和病重的退伍军人,以及已婚人士,更有可能接受社区治疗,设置之间没有显著的成本差异.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
背景情况:
- 任务和选择法案使退伍军人健康管理局 (VA) 能够增加社区为退伍军人采购免疫疗法.
- 本研究探讨了VA系统中社区免疫疗法服务的日益增长趋势.
研究的目的:
- 在VA患者中确定基于社区的免疫疗法治疗的预测因素.
- 评估不同社区治疗环境 (医院门诊部门与医生办公室) 免疫治疗成本和利用率的变化.
主要方法:
- 对2015年至2020年期间开始免疫治疗的21,257名患者的索赔数据的分析.
- 评估VA社区免疫疗法的增长.
- 多变量逻辑回归用于根据患者人口统计和临床因素确定预测因素.
- 医院门诊部门 (HOPD) 和医生办公室 (PO) 设置之间的利用率和成本的比较.
主要成果:
- 在VA的社区免疫疗法显著增加,从2015年的5.3%增加到2020年的32.1%,总成本从610万美元增加到1.87亿美元.
- 老年人,已婚者,农村人士和患有更多并发症的患者更有可能接受社区治疗;黑人患者更有可能在VA内接受治疗.
- 在这两种情况下,呼吸道癌症是最常见的诊断.
- 在社区免疫疗法中,HOPD和PO之间没有发现药物单位,药物单位成本或每次访问成本的显著差异.
结论:
- 在接受社区治疗的VA患者的医院门诊部门和医生办公室之间,免疫治疗的药物成本是可比的.
- 该研究强调了影响退伍军人选择社区免疫疗法设置的人口和临床预测因素.
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