麻醉质量改善参与是否会在外科质量协作人群中带来增量节省? 一个回顾性的观察性研究
Allison M Janda1, Michelle T Vaughn1, Douglas A Colquhoun1
1From the Departments of Anesthesiology.
Anesthesia and analgesia
|September 7, 2023
概括
参与麻醉学绩效改进和报告交换 (ASPIRE) 协作质量倡议 (CQI) 的参与,显著减少了重大手术的总支付. 这种麻醉CQI证明了大幅节省医疗保健成本的潜力.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 麻醉学 麻醉学
- 卫生经济学 卫生经济学
背景情况:
- 手术领域的协作质量倡议 (CQI) 已经节省了成本,但麻醉CQI的财务影响仍然被低估.
- 麻醉学绩效改进和报告交易所 (ASPIRE) 是一家医院的合作伙伴关系,专注于改善麻醉的质量和结果.
- 这项研究调查了ASPIRE参与是否会导致可衡量的医疗保健成本降低.
研究的目的:
- 评估参与ASPIRE麻醉CQI与医疗保健成本节省之间的关联.
- 测试假设ASPIRE参与减少了大量手术手术的总支付.
主要方法:
- 一项追溯观察性研究,比较8家ASPIRE医院 (1组) 的病期支付数据与8家匹配的非ASPIRE对照医院.
- 使用密歇根价值协作 (MVC) 数据对密歇根州蓝十字蓝盾和医疗保险FFS计划的价格标准化,风险调整支付进行分析.
- 差异分析比较了ASPIRE (2014) 之前和ASPIRE (2016年6月至2017年7月) 之后的时间.
主要成果:
- 与对照组相比,ASPIRE医院在大型,大批量的手术中,总发作支付 (-719美元) 在统计学上显著下降.
- 在ASPIRE医院的30天出院后支付 (-354美元) 也出现了显著的减少.
- 亚组分析显示,ASPIRE参与医院的关节置换病例总支付大幅下降 (- 860美元).
结论:
- 参与ASPIRE麻醉学CQI与特定重大外科手术的总发作支付较低有关.
- 麻醉CQI,如ASPIRE,是减少整体医疗保健开支的可行策略.
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