跨学科护理团队的护理管理是否改善了健康质量并证明了成本效益?
F Cardwell Feagin1, Larry R Hearld2, Nathan W Carroll3
1Viva Health, Inc., Birmingham, AL, USA.
Medical care research and review : MCRR
|September 8, 2023
概括
跨学科护理团队 (IDCT) 显著降低了高风险医疗保险优势患者的医疗保健成本. 该计划产生了大量的净储蓄,证明了对管理弱势群体的成本效益.
科学领域:
- 医疗保健管理的管理
- 卫生经济学 卫生经济学
- 人口健康 人口健康
背景情况:
- 识别和管理高风险患者对于控制医疗保健成本至关重要.
- 医疗保险优势 (MA) 受益人代表着一个具有复杂健康需求的大量人口.
- 传统的护理管理计划可能无法最佳地识别或参与所有高风险个体.
研究的目的:
- 评估跨学科护理团队 (IDCT) 计划对成本和质量结果的影响.
- 评估一种新算法的有效性,以识别高风险的MA受益者来进行护理管理.
- 为了确定IDCT护理管理计划的投资回报率.
主要方法:
- 一个新的算法从48,235名受益者中识别出400名高风险的MA受益者.
- 252名患者被纳入IDCT护理管理计划;148名患者没有被纳入.
- 第二个比较组包括660名被转诊但未被算法选择的患者.
- 结果在干预后1年被评估.
主要成果:
- 与非登记者 (每月1,121.76美元) 和仅通过转诊的患者 (每月1,625.61美元) 相比,IDCT计划的登记者经历了医疗保健成本的降低.
- 该计划净节省了190万美元,超过了运营成本.
- 这些发现表明,在管理高风险患者群体方面,成本效益显著.
结论:
- 跨学科护理团队 (IDCT) 有效地管理高风险人群,从而大幅降低成本.
- 一个新的选择算法提高了护理管理计划的成本效益.
- 改善患者选择和团队相互依赖是成功管理高风险患者的关键.
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