协作护理模式对医疗支出的影响
Courtney Benjamin Wolk1, Eric Wilkinson, Cecilia Livesey
1University of Pennsylvania, 3535 Market St, Philadelphia, PA 19104.
将心理健康纳入初级保健的协作护理并没有增加整体医疗保健成本. 这项研究是对使用新的CMS计费代码进行协作护理的方案的首次经济分析.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 心理健康服务 心理健康服务
背景情况:
- 协作护理模式将心理健康服务整合到初级保健机构中.
- 美国医疗保险和医疗补助服务中心 (CMS) 在2017年制定了新的计费代码,使协作护理的报销成为可能.
- 了解这些新的退款代码的经济影响对于广泛采用至关重要.
研究的目的:
- 通过新的CMS计费代码来衡量协作护理计划对整体医疗支出的影响.
- 评估将行为健康整合到初级保健中的成本效益.
主要方法:
- 采用近乎实验性的设计,采用了825名商业保险和医疗保险患者的样本,这些患者接受了协作护理.
- 倾向性得分匹配被用来创建可比较的569名患者 (治疗和控制) 的组.
- 差异回归分析评估了对医疗总支出的影响,包括医疗,精神病和药品索赔.
主要成果:
- 合作护理患者的平均总医疗费用在三个月后开始下降,并在第七个月下降到控制组成本以下.
- 差异差异分析显示,每个会员每月平均节省29.35美元,这一数字并不显著.
- 协作护理和其他精神卫生服务的直接成本增加,而住院费用显示不显著的减少.
结论:
- 实施针对行为健康需求的协作护理服务并没有导致医疗保健支出总体增加.
- 本研究提供了使用新的CMS退款代码的协作护理计划的初步经济评估.
- 这些发现表明,协作护理可以整合,而不会显著增加医疗保健成本.
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