瘤学和息护理整合模型:在巴西医院设置中的成本分析研究
Tânia V V Guimarães1, Alessandro G Campolina1, Luciana M Rozman2
1Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
The American journal of hospice & palliative care
|February 20, 2024
概括
将息治疗与瘤学相结合,降低了医疗保健成本,并在生命的最后一个月进行可能不适当的治疗. 这种新型的模型减少了急诊,住院和癌症治疗,特别是对于晚期癌症患者.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 圣保罗州癌症研究所 (ICESP) 在2019年推出了一种综合瘤和息护理模型.
- 本研究评估了这种综合模型对医疗保健资源利用和相关成本的影响.
研究的目的:
- 评估将息护理专家纳入瘤护理对医疗保健资源利用和成本的影响.
- 确定这个综合模型是否减少了生命最后一个月潜在不合适的治疗.
主要方法:
- 对2月 (实施前) 和11月 (实施后) 在ICESP死亡的患者的回顾性分析.
- 从电子医疗记录中提取的医疗保健利用数据 (紧急诊所,住院/ICU入院,化疗,放射治疗).
- 从行政数据库中获得的单位成本用于计算医疗保健总成本.
主要成果:
- 在整合后,每名患者的平均成本从13,226.29美元下降到11,445.82美元 (P = .007).
- 观察到手术病房日,急诊室访问,化疗和放射治疗疗程的显著减少.
- 在生命的最后30天内,化疗和放射治疗的费用从16,924.45美元下降到7851.65.5美元.
- 在ECOG 3-4的患者中,减少更为显著.
结论:
- 综合瘤和息护理模型与减少医疗保健利用率和成本有关.
- 这种模式似乎可以减少生命结束时提供潜在不合适的治疗.
- 研究结果表明,对患者护理和医疗资源管理都有好处.
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