避免入学的价值:对在合并服务中一年的活动进行成本后果分析
Carme Hernandez1,2, Carme Herranz3,4, Erik Baltaxe3,5
1Hospital at Home Unit, Hospital Clínic de Barcelona. Villarroel, 170, 08036, Barcelona, Spain. chernan@clinic.cat.
Cost effectiveness and resource allocation : C/E
|April 15, 2024
概括
与传统住院相比,在家住院避免 (HaH-HA) 显著降低了死亡率和医疗保健成本. 这项现实世界的研究证明了HaH-HAHA.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 急性护理的交付模式
- 卫生经济学 卫生经济学
背景情况:
- 家庭医院 (HaH) 为急性护理提供了许多好处,但成本效益仍在争论中.
- 评估避免住院的成本效益 (HaH-HA) 对于优化急性护理策略至关重要.
- 在巴塞罗那十年的高质量交付为此分析提供了强大的背景.
研究的目的:
- 评估健康结果和医院规避的分析成本 (HaH-HA) 在一个建立的 HaH 服务.
- 在死亡率,再入院,急诊室访问和直接医疗保健成本方面,将HaH-HA与传统的入院进行比较.
主要方法:
- 从卫生系统的角度进行回顾性成本后果分析.
- 将哈哈哈的第一个发作 (2017-2018年急诊室入院) 与 propensity-score 匹配的传统住院控制器进行比较.
- 评估死亡率,30天再入院,急救诊所和直接医疗保健费用.
主要成果:
- 与对照组 (n=441) 相比,HaH-HA患者 (n=441) 的发作死亡率显著降低 (0%与4.3%相比;p<0.001).
- 虽然30天的再入院率相似,但HaH-HA的急诊次数较少 (6.3%对8.1%;p=0.044).
- 与对照组 (2,171欧元) 相比,HaH-HA的平均事件成本显著低于1,078欧元,并且在释放后的成本节省显著 (p<0.001).
结论:
- 在现实世界中,家庭医院规避表现出卓越的性能和显著的成本降低.
- 确定具体的节省成本来源可以促进更广泛的实施和扩大医院规避策略.
- HaH-HA代表了急性护理提供一个有价值和成本效益的替代方案.
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