管理慢性病的并发症可以减少利用率和成本
Yong Li1, Kanchan Barve2, Meghan Cockrell2
1Humana Healthcare Research, Humana Inc, 500 W Main Street, Louisville, KY, 40202, USA. yli4@humana.com.
BMC health services research
|December 16, 2023
概括
在慢性病 (CKD) 患者中,糖尿病和高血压的有效管理降低了医疗保健的使用和成本. 控制葡萄糖和血压是CKD护理协调的关键.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内分泌学 在内分泌学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 慢性病 (CKD) 的管理是复杂的,特别是在并发性糖尿病和高血压.
- 了解医疗保健计划对管理这些伴随性疾病的观点,对于优化患者的治疗结果至关重要.
- 这项研究解决了关于CKD患者有效的并发性疾病管理和医疗保健资源利用 (HCRU) 之间的关联的知识差距.
研究的目的:
- 评估伴随性糖尿病和/或高血压和HCRU在慢性病患者的有效管理之间的关联.
- 从健康计划的角度分析疾病控制对医疗保健利用的影响.
- 确定影响CKD群体中HCRU的关键管理策略.
主要方法:
- 使用Humana研究数据库 (2017) 的回顾性队列研究.
- 包括患有CKD阶段≥3a的患者,在Medicare Advantage处方药计划中注册了≥12个月的前后指数日期.
- 排除了末期病,移植或临终关怀预指数的患者. 评估了对监测 (HbA1c),药物 (降血糖,心血管,ACEi/ARB) 和提供者访问 (科医生/PCP) 的遵守. HCRU评估了12个月后的指数.
主要成果:
- 分析了一组241,628名患者 (55%为女性,77%为白人,平均年龄为75岁) 患有第三期CKD.
- 符合良好的疾病管理标准的患者的住院住院率显著降低 (降低40%) 和急诊室访问率 (降低30%).
- 管理良好的患者的月度医疗费用总额比不符合标准的患者减少了多达17%.
结论:
- 在CKD患者中,并发性糖尿病和高血压的有效管理与减少医疗保健资源利用率和降低整体成本有关.
- 对CKD患者的护理协调计划应优先考虑严格的葡萄糖和血压控制.
- 优化对这些常见的并发病的管理可以带来显著的经济效益和改善患者护理途径.
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