基于ACO的儿科护理管理的成本,利用以及患者和家庭的经验
Katherine H Schiavoni1,2,3, Megan Flom1, Karen J Blumenthal1,3,4
1Mass General Brigham, Population Health Management, Somerville, Massachusetts.
Pediatrics
|November 28, 2023
概括
负责护理组织 (ACO) 的儿科护理管理显著降低了儿童的总医疗费用和医疗保健利用率. 该计划还改善了护理协调和家庭满意度,证明了其有效性.
科学领域:
- 儿科医疗保健管理的管理
- 医疗保健服务研究 医疗服务研究
- 负责的护理组织 负责的护理组织
背景情况:
- 具有特殊医疗保健需求的儿童和青少年 (CYSHCN) 经历了高医疗保健利用率和分散的护理.
- 负责任的护理组织 (ACO) 越来越多地实施儿科护理管理,以提高质量和降低成本.
- 本研究探讨了ACO内儿科护理管理对CYSHCN的医疗保健结果的影响.
研究的目的:
- 评估儿科护理管理对医疗总费用 (TME) 和利用率的影响.
- 评估对护理协调的感知质量,未满足的需求以及患者/家庭的经验.
- 根据付款人,风险评分,护理经理纪律和行为健康诊断来检查差异性影响.
主要方法:
- 采用了混合方法方法,包括用近似阶段形设计进行索赔数据分析.
- 进行了参与者调查和半结构面试.
- 这项研究包括了1321名参与医疗补助或商业ACO的多学科,初级保健嵌入式护理管理的患者.
主要成果:
- 招生后的总医疗费用 (TME) 显著下降 (-$645.48 PMPM).
- 紧急病房和住院患者的使用率显著下降 (分别为-29%和-82%).
- 报告了对护理协调的高度满意度 (87.2%),其中81.5%没有未满足的健康需求,尽管较高的风险分数与更多未满足的需求相关.
结论:
- 在多支付 ACO 内的儿科护理管理有效地减少了 TME 和利用率.
- 该计划提供高质量的护理协调,解决教育和家庭压力.
- 参与者的高满意度表明对患者和家庭体验产生了积极影响.
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