远程医疗对医疗保险利用,支出和质量的影响,2019-22
Carter H Nakamoto1, David M Cutler2, Nancy D Beaulieu3
1Carter H. Nakamoto, Harvard University, Boston, Massachusetts.
Health affairs (Project Hope)
|April 17, 2024
概括
远程医疗的使用在流行病后更高. 增加的使用与更多的门诊访问,更高的支出和更好的药物坚持相关,但没有减少住院治疗.
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
- 医疗保健政策 医疗保健政策
背景情况:
- 在COVID-19大流行期间,远程医疗的使用量急剧增加,并且仍然很高.
- 关于远程医疗服务报销的持续辩论需要对其影响的证据.
- 了解远程医疗使用与医疗保健结果之间的关联对于政策决策至关重要.
研究的目的:
- 估计卫生系统中远程医疗使用率较高与患者利用率,医疗保健支出和护理质量之间的关联.
- 分析医疗保险患者数据,以比较高远程医疗采用率和低远程医疗采用率的卫生系统之间的结果.
主要方法:
- 对2020年和2021-22年医疗保险患者数据的回顾性分析.
- 基于远程医疗访问量分类为四分之一的卫生系统的比较.
- 评估关键指标,包括门诊总数,急诊室访问,医疗保健支出,药物服药,住院和预防护理收到.
主要成果:
- 2020年,使用远程医疗的最高四分之一的卫生系统每人有2.5次远程医疗访问 (26.8%的总访问量),而最低四分之一的卫生系统只有0.7次 (9.5%).
- 从2021-22年开始,更高的远程医疗使用与门诊总次数的2.2%的相对增加和非COVID-19急诊室访问的2.7%的相对减少有关.
- 远程医疗的使用增加与每位患者支出增加1.6%以及对甲胺和他类药物的坚持改善相关,但住院治疗或预防护理没有显著变化.
结论:
- 远程医疗的更大采用与门诊患者使用率的增加和医疗保险受益者改善的药物坚持有关.
- 虽然远程医疗的使用可能会减少急诊室的访问,但它与更高的整体医疗保健支出有关.
- 需要进一步的研究,才能充分了解远程医疗对医疗保健成本和患者结果的长期影响.
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