一个针对易受伤害的急诊室患者的综合实践单位的成果
Deepa Borde1, Denny Fe G Agana-Norman2, Robert Leverence3
1University of Florida College of Medicine, 1600 SW Archer Rd, Gainesville, FL, 32608, USA.
BMC health services research
|December 22, 2023
概括
综合实践单位 (IPU) 显著减少了超级使用者 (SU) 患者的医疗保健利用率. 这些多学科团队显示,无保险的SU和高频用户的好处更大.
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
- 患者护理管理的管理.
背景情况:
- 综合实践单位 (IPU) 为昂贵的超级使用者 (SU) 患者提供多学科护理.
- 个人保险单位对保险人与未保险人的影响以及不同频率水平 (超高与高) 需要进一步调查.
研究的目的:
- 评估IPU在降低USS医疗保健利用率方面的有效性.
- 为了比较IPU对保险人的影响与未保险的SU和不同SU频率组.
主要方法:
- 一个回顾性分析,比较6个月前后的IPU招生为SUs.
- 测量结果包括ED访问,ED成本,住院,住院日和住院成本.
- 公共保险和无保险患者之间进行了比较,以及超高频率的SU (≥8次ED访问/6个月) 和高频率的SU (4-7次ED访问/6个月) 之间进行了比较.
主要成果:
- 观察到的总体减少:住院病人的25%,住院日数的23%,住院费用的26%.
- 与公共保险 SU 相比,无保险的 SU 在医疗保健利用率下降的幅度更大.
- IPU减少了超高频 SU 的住院治疗,但在超高频和高频 SU 组之间,整体利用影响没有显著差异.
结论:
- 专门的IPU有效地减少了SU人群的急性护理利用率.
- 对于没有保险和高频率的SU患者来说,IPU的好处尤其明显.
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