通过数字参与扩大护理协调:一个阶段式形试验,评估再接收
Alexandra Polovneff, Neemit Shah, Abhishek Janardan
1Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226.
The American journal of managed care
|February 21, 2024
概括
一个患者出院后的数字参与 (PDDE) 计划并没有显著减少低风险患者的再入院. 然而,PDDE扩大了服务不足的患者群体的护理协调资源.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 数字健康数字健康
- 患者护理管理的管理.
背景情况:
- 医院出院后的护理过渡非常关键,但资源密集.
- 传统的电话护理协调面临着可扩展性挑战.
- 开发了一项患者出院后数字参与 (PDDE) 计划,以加强护理协调.
研究的目的:
- 评估PDDE计划对30天再入院的影响.
- 评估PDDE在减少低风险患者再入院的有效性.
- 确定PDDE是否可以补充中高风险患者的护理协调.
主要方法:
- 一个务实的,阶梯集群随机试验,涉及5个实施波.
- 5490例住院出院病人的分层,按再接收风险划分 (低,中,高).
- 使用混合效应逻辑回归的治疗意图和治疗对受治疗者的分析.
主要成果:
- 在低,中,或高风险患者群体中,PDDE干预并没有显著影响再入院率.
- 对治疗者进行的治疗对待分析也显示,PDDE使用者之间再接收的情况没有显著差异.
- 这项研究包括5490次出院 (2735次对照,2755次干预).
结论:
- 该PDDE计划扩大了以前无法获得此类服务的低风险患者的护理协调资源.
- 该PDDE计划没有显著影响减少重入院.
- PDDE有效地增加了患者-提供者接触点,为资源有限的设置提供了一个可扩展的解决方案.
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