电子信息交换对医疗保险受益者在30天再入院期间重复成像的影响
Sara D Turbow1, Steven D Culler, E Camille Vaughan
1Emory University School of Medicine, 49 Jesse Hill Jr Dr SE, Atlanta, GA 30303.
The American journal of managed care
|February 21, 2024
概括
电子健康信息共享并没有减少医疗保险再入院的重复成像. 分断的护理增加了老年人没有阿尔茨海默病的重复成像几率,即使医院使用健康信息交换 (HIEs).
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗信息学 医疗信息学
- 老年医学 老年医学
背景情况:
- 在再入院期间重复成像是对医疗保健成本和患者安全的担忧.
- 实施了电子健康信息交换 (HIE),以改善护理协调和减少冗余测试.
- 对HIEs对重复成像的影响,特别是在分散的护理环境中,需要进一步调查.
研究的目的:
- 在30天的医疗保险再入院中检查电子健康信息共享和重复成像之间的关联.
- 为了比较碎片化和非碎片化再入院的重复成像率.
- 评估健康信息交换 (HIEs) 在减轻阿尔茨海默病 (AD) 和没有阿尔茨海默病 (AD) 的老年人中碎片化再入院的重复成像方面的作用.
主要方法:
- 一项使用2018年国家医疗保险数据的队列研究.
- 对30天再入院的分析,比较在相同的身体系统上重复成像的碎片化和非碎片化护理.
- 使用后勤回归模型来评估HIE参与和重复成像之间的关系,并对共变量进行调整.
主要成果:
- 总体而言,14.3%的受益者在再接收期间经历了重复成像.
- 碎片化再入院与在没有阿尔茨海默氏症 (AD) 的老年人中重复成像的几率提高5%有关.
- 医疗信息交换 (HIE) 的使用并没有缓解这种关联;同一HIE内的碎片化再入院显示重复成像的几率高出6% (aOR,1.06).
- 对于患有AD的老年人来说,没有观察到重复成像几率的显著差异.
结论:
- 目前的健康信息交换 (HIE) 实施似乎没有减少重复成像在医院再入院.
- 分断的护理途径增加了重复成像的可能性,特别是在没有阿尔茨海默病的老年人中.
- 需要进一步的研究来优化HIE的功能和集成,以改善护理协调和减少医疗保健浪费.
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