大型手术前后的医疗保健利用轨迹分析
Aaron Tarnasky1, Justin Ludwig2, Andrew Bilderback3
1Department of Anesthesiology, UPMC.
Annals of surgery
|December 12, 2023
概括
手术可以将患者从低到高的医疗保健使用量转移,特别是那些有脆弱性的患者. 在手术前确定这些患者,可以制定量身定制的护理策略,以管理手术后使用率的增加.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 老年人手术是一门老年人手术.
- 卫生经济学 卫生经济学
背景情况:
- 脆弱的患者面临着更糟糕的外科手术结果和更高的成本.
- 手术后脆弱性对长期医疗保健利用的影响还没有得到充分研究.
研究的目的:
- 描述选择性手术前后的医疗保健利用模式.
- 确定术前脆弱性与这些利用模式之间的关联.
主要方法:
- 对29,067例成年人手术遭遇 (2016-2020年) 的回顾性队列分析.
- 使用风险分析指数用于术前脆弱性评估.
- 索赔数据的基于组的轨迹建模,以确定利用集群.
主要成果:
- 在手术后确定了四种不同的医疗保健利用轨迹.
- 大多数患者回到了他们手术前的利用状态 (低,中,高).
- 5.7%从低的手术前利用率过渡到高的手术后利用率;由多变量模型预测.
结论:
- 一个重要的手术患者小组在手术后过渡到高医疗保健利用率.
- 多变量建模可以识别患有这种过渡风险的患者.
- 有机会为高利用率的外科患者量身定制护理.
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