在高风险出院患者中过渡性护理计划的有效性:关于节省成本,出院后再接收和急诊室访问的准实验性研究
Moonseong Heo1, Kevin Taaffe2, Ankita Ghadshi2
1Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA.
International journal of environmental research and public health
|December 8, 2023
概括
过渡期护理计划 (TCP) 显著降低了医院再入院和出院患者的医疗费用. 虽然急诊室的访问没有显著影响,但TCP在降低整体事件成本和超过目标价格方面被证明是有效的.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健管理的管理
- 患者的治疗结果.
背景情况:
- 过渡期护理计划 (TCP) 旨在减少医院再入院和退院后急诊室 (ED) 使用率.
- 这些计划涉及医院护理团队,在离开医院后为患者提供后续护理.
- 主要目标是降低医疗保健成本并改善患者的治疗结果.
研究的目的:
- 评估过渡期护理计划 (TCP) 在降低医疗保健成本方面的有效性.
- 评估TCP对医院再入院和退院后30至90天内急诊室 (ED) 访问的影响.
- 确定TCP是否会影响每次护理的总成本和超过目标价格的病例的发生.
主要方法:
- 从医疗保险和医疗补助服务中心 (BPCI) 计划和电子健康记录中获得的索赔数据的回顾性分析.
- 数据是从2017年11月至2020年7月期间的格林维尔纪念医院提取的.
- 完成TCP ("TCP毕业生",N=85) 和没有完成TCP ("没有毕业",DNG,N=1310) 的患者之间的结果比较,重点关注30日和90天的再入院,急救诊所访问,总成本和超过BPCI目标价格的成本.
主要成果:
- 与DNG组相比,TCP毕业生30天 (7.1%对14.9%) 和90天 (15.5%对26.3%) 的再录取率明显较低 (p < 0.05).
- 在TCP毕业生组中,总成本超过目标价格的情节明显较低 (25.9%与36.6%,p = 0.031).
- 对于TCP毕业生来说,每次病发的总成本明显较低 (22,439美元对28,633美元,p = 0.018),而30天和90天的ED访问率在各组之间没有显著差异.
结论:
- 过渡期护理计划 (TCP) 与出院后重入医院病例的显著减少有关.
- TCP有效地降低了每次病发的医疗保健总成本,并减少了超过目标价格的病发的发生率.
- 建议使用严格的设计和个人级数据进行进一步的研究,以验证这些关于TCP有效性的发现.
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