一个集中的人口健康药房计划对基于价值的医疗保险患者的影响
Journal of the American Pharmacists Association : JAPhA
|September 24, 2023
概括
一个新的远程医疗药房计划通过解决出院后的药物问题,显著减少了医院再入院. 这种创新方法改善了患者护理,并在基于价值的护理模式中降低了医疗保健成本.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 药房实践 在药房实践.
- 以价值为基础的护理
背景情况:
- 纪念医疗保健系统 (MHS) 加入了医疗保险和医疗补助服务中心 (CMS) 护理改善捆绑支付高级计划,以提高患者护理和降低成本.
- 药物治疗问题 (MTPs) 提出了挑战,导致创建了一个集中式远程医疗人口健康药房计划,以提供退院后的支持.
研究的目的:
- 实施一个全面的退院后药物支持计划.
- 在90天的程序风险期内解决药物治疗问题 (MTP).
- 为了降低90天的医院再入院率.
主要方法:
- 建立统一的工作流程和双重药房团队方法,涉及人口健康药剂师 (PHP) 和人口健康注册护士 (PHRNs).
- 利用一个集中的远程医疗模型,与电子健康记录 (EHR) 集成的工具,用于退院后的电话接触.
- 使用描述性统计,克鲁斯卡尔-瓦利斯测试和多变量回归模型进行了回顾性分析.
主要成果:
- 在七个月的时间里,PHPs进行了801次电话访问,解决了433个MTP,解决率为94%.
- 该计划实现了90天再接收率从35%降至10%-17% (P <0.01) 的统计显著降低.
结论:
- 集中式远程医疗人口健康药房计划通过解决MTP和减少再入院,有效地改善了患者的治疗结果.
- 该计划是将药剂师纳入基于价值的护理计划的成功模式,以加强药物管理和患者护理.
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