开发基于疾病的医院级诊断强度指数
Michael I Ellenbogen1, Leonard S Feldman2, Laura Prichett3
1Department of Medicine, 1500 Johns Hopkins School of Medicine , Baltimore, MD, USA.
Diagnosis (Berlin, Germany)
|April 21, 2024
概括
一个新的诊断强度指数 (DII) 量化了医院对特定疾病的成像使用情况. 较高的DII分数与成像成本的增加相关,突出显示了潜在的低价值护理.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医学经济学 医学经济学
- 护理的质量 护理的质量
背景情况:
- 低价值的护理增加了医疗保健成本和患者的伤害.
- 在医院层面量化诊断强度对于识别和解决过度使用先进成像技术至关重要.
- 需要一个简单的,验证的指数来衡量医院诊断强度.
研究的目的:
- 开发和验证诊断强度指数 (DII) 以量化医院级诊断强度.
- 通过在诊断可能不需要成像的患者中使用高级成像来定义诊断强度.
- 描述与高诊断强度相关的医院特征.
主要方法:
- 使用国家住院患者数据库数据用于住院治疗.
- 开发了DII,使用八个指标来表示特定诊断的高级成像流行率.
- 通过使用医疗保险成本指标,达特斯地图数据和通过多级回归的医院利用指数对DII进行外部验证.
主要成果:
- 新的DII证明了与五个验证措施中的四个具有剂量依赖的相关性.
- 在较高的DII三位数和更高的成像成本之间发现了显著的关联 (OR 3.41).
- DII有效地捕捉了医院间诊断强度的变化.
结论:
- 一组有限的条件和成像可以可靠地推断出更广泛的医院诊断强度.
- DII提供了一种工具,以了解与潜在低价值护理相关的医院特征.
- 该指数可以为旨在减少不必要的诊断测试和提高医疗保健价值的战略提供信息.
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