养老院低估了抗精神病药物的使用情况,但过度报告了符合适当使用条件的诊断
Amanda C Chen1, David C Grabowski2
1Harvard Graduate School of Arts and Sciences.
Health affairs scholar
|February 7, 2024
概括
养老院抗精神病药物报告显示存在差异. 设施报告低估了药物使用,但与医疗保险索赔相比,高估了合格诊断.
科学领域:
- 老年人药房 老年人药房
- 医疗保健服务研究 医疗服务研究
- 医疗保健中的数据质量
背景情况:
- 在美国养老院中使用抗精神病药物是一个重大问题.
- 了解这些药物的报告特征对于准确的监督至关重要.
研究的目的:
- 评估美国养老院抗精神病药物报告和诊断报告的一致性.
- 为了比较设施报告的最低数据集 (MDS) 数据与医疗保险索赔数据的准确性.
主要方法:
- 连接的医疗保险索赔和MDS评估为长期住宿养老院居民 (2018年1月至2019年12月).
- 在数据来源中计算了抗精神病药物和合格疾病 (精神分裂症,图雷特综合征,亨廷顿病) 的报告率.
- 分析了根据双重资格和种族的报告变化.
主要成果:
- 与医疗保险索赔相比,医疗机构报告的抗精神病药物使用报告不足 (87%的报告率).
- 符合条件的诊断在MDS中过度报告,有显著的差异:精神分裂症 (54.8%),图雷特综合征 (46.5%) 和亨廷顿病 (72.4%) 缺乏相应的索赔诊断.
- 双重资格居民报告使用抗精神病药物的几率更高,而黑人居民的几率更低.
结论:
- 在机构报告的MDS和医疗保险对抗精神病药物和其在养老院的合格诊断的索赔之间存在重大报告差异.
- 这些发现强调了医疗保险和医疗补助服务中心 (CMS) 需要调查这些报告不一致的来源.
- 解决这些差异对于准确监测和在长期护理环境中适当使用抗精神病药物至关重要.
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