医生层面的护理连续性和患者结果在所有申请人索赔数据库中
Mingliang Dai1, Zachary J Morgan2, Kyle Russel2
1From the American Board of Family Medicine (MD, ZJM, LEP, AWB); Virginia Health Information (KR); Virginia Center for Health Innovation (BAB); Department of Family and Community Medicine at the University of Kentucky (LEP); Center for Professionalism and Value in Health Care (AWB). mdai@theabfm.org.
医生级护理连续性 (Phy-CoC) 与更高的医疗保健成本有关,但与可预防的住院治疗无关. 这项研究表明,增加Phy-CoC可能会意外地增加所有保险类型的患者的总成本.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 初级医疗保健医学 一级医疗保健医学
- 医疗保健经济学 医疗保健经济学
背景情况:
- 医生级护理连续性 (Phy-CoC) 是初级保健质量的新兴衡量标准.
- 现有关于Phy-CoC的研究是有限的,特别是在不同的患者群体和保险类型中.
- 这项研究解决了对超出医疗保险受益者的Phy-CoC影响的更广泛证据的需求.
研究的目的:
- 评估基于全面板的Phy-CoC得分与患者的结果之间的关联.
- 扩大Phy-CoC的分析范围,包括所有年龄和保险类型的患者.
- 调查更高的Phy-CoC对医疗保健成本和住院治疗的潜在意外影响.
主要方法:
- 使用弗吉尼亚全付款人索赔数据库 (VA-APCD) 进行横截面分析.
- 通过平均患者的Bice-Boxerman指数得分来计算Phy-CoC得分,加权于总访问量.
- 测量的患者结果包括总医疗费用和可预防的住院治疗.
主要成果:
- 较高的Phy-CoC与成人患者群体的总成本增加7%-11.8%有关.
- 较高的Phy-CoC与可预防住院住院的几率之间没有发现显著的关联.
- 物理-CoC和总成本之间的关联因患者年龄,并发症,保险支付人和医生专业而异.
结论:
- 基于全面板的更高的Phy-CoC与医疗保健总成本有关,但与可预防的住院治疗无关.
- 增加的Phy-CoC可能会导致显著的,意想不到的成本影响.
- 需要进一步的研究来了解护理连续性和医疗保健支出之间的复杂关系.
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