具有多重疾病的高成本个体的疾病模式:初级保健中的回顾性横截面研究
Marina Soley-Bori1, Mark Ashworth1, Alice McGreevy1
1London borough of Lambeth.
概括
患有多种长期疾病 (LTC) 的高成本患者表现出多种疾病模式,而不是由任何单一疾病主导. 整合精神和身体健康护理对于改善结果和降低成本至关重要.
科学领域:
- 卫生经济学 卫生经济学
- 主要护理研究的研究.
- 多发病性疾病研究.
背景情况:
- 具有多重疾病的高成本个体对医疗保健系统构成重大负担.
- 这些患者面临较低护理质量和不良健康结果的风险.
研究的目的:
- 为了比较高成本和低成本的个体与多病症.
- 在这些人群中识别出不同的疾病模式和集群.
主要方法:
- 来自伦敦41家初级保健机构 (2019/2020) 的电子病历的横截面研究 (2019/2020).
- 多发病症定义为≥2种长期疾病 (LTC).
- 隐性类分析用于探索高成本患者的疾病聚类.
主要成果:
- 在386,238名成年人中,26%的人患有多重疾病;前20%的高成本组承担了53%的总成本.
- 与成本较低的患者相比,高成本的患者表现出疾病组合多样性的三倍.
- 焦虑,慢性疼痛和抑郁是最昂贵的三重症 (5%);在五个确定的患者群中,三个群中普遍存在心理健康状况.
结论:
- 具有多种疾病的高成本个体在LTC中表现出显著的异质性,没有单一的主导疾病组合.
- 心理健康状况的普遍性强调了综合精神和身体健康护理的需要.
- 改善护理协调可能会提高结果并降低医疗保健支出.
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