为医疗补助保险人提供以股权为中心的退休后支持:为1型混合有效性实施方案 阶段性子集群 随机控制试验
J Margo Brooks Carthon1, Heather Brom1, Marsha Grantham-Murrillo2
1University of Pennsylvania, Philadelphia, PA, United States.
JMIR research protocols
|March 26, 2024
概括
通过解决社会需求和系统性障碍,THRIVE计划改善了患有慢性疾病的医疗补助患者的护理过渡. 这种以公平为重点的干预措施旨在减少医院再入院和急诊室访问,提高出院后的结果.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
- 实施科学 实施科学
背景情况:
- 对于患有慢性疾病的医疗补助保险人来说,住院后结果的差异仍然存在.
- 现有的过渡期护理干预措施往往缺乏整体方法,狭地关注特定的年龄组或个体行为.
- THRIVE (翻译性健康研究和创新价值提升) 途径是一个以公平为重点的干预措施,旨在解决这一群体的健康和系统性障碍的社会决定因素.
研究的目的:
- 为了检查与通常护理相比,接受THRIVE支持的参与者之间的转诊模式,30天再入院和急诊室使用情况.
- 评估THRIVE临床途径的实施情况,评估其忠实性,可行性,适当性和可接受性.
主要方法:
- 在18个月的时间里,顺序随机地向案例经理推出THRIVE,分为三个步骤.
- 纳入标准:居住在费城的医疗补助保险人/符合条件的成年人 (18岁以上),住院时间超过24小时,并出院.
- 数据收集包括与临床医生进行的定性访谈以及从电子健康记录中获得的定量卫生服务使用数据.
主要成果:
- 数据收集从2023年3月到2024年7月进行.
- 该项目于2023年1月获得资金,IRB于2023年3月批准.
- 预计结果将于2025年公布.
结论:
- "Thrive"途径旨在减少差异,并改善Medicaid患者的退院后护理过渡.
- 该干预措施利用以公平为重点的病例管理和电子健康记录来识别急需患者并改善护理协调.
- 这项研究将提供对以公平为重点的原则在干预设计和实施和结果的评估中的有效性的见解.
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