在双重注册的退伍军人中进行低价值子宫癌查后,护理级联
Aimee N Pickering1,2, Xinhua Zhao1, Florentina E Sileanu1
1Center for Health Equity Research and Promotion (CHERP), VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
Journal of the American Geriatrics Society
|May 9, 2024
概括
在双重注册的退伍军人健康管理局 (VA) 和医疗保险患者中,低价值的宫癌查导致更多的下游服务和更高的成本. 检查所有系统的护理对于了解低价值护理的全部影响至关重要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 老年医学 老年医学
- 在瘤学瘤学.
背景情况:
- 在退伍军人健康管理局 (VA) 和医疗保险 (Medicare) 双重注册的退伍军人通常在最初的低价值服务后获得后续护理.
- 在这个人群中,描述低价值的宫癌查和相关护理级联是必不可少的.
研究的目的:
- 确定低价值宫癌查的频率和成本.
- 为了分析65岁以上的女性退伍军人中随后的护理级联,她们患子宫癌的风险较低,在VA和医疗保险中双重注册.
主要方法:
- 使用VA和医疗保险行政数据进行的回顾性队列研究 (2015-2019财年).
- 2018财年低价值宫癌查级联服务费率和成本的比较.
- 使用治疗权重的逆概率来调整患者和设施共变量.
主要成果:
- 在20972名符合条件的退伍军人中,有494名 (2,4%) 接受了低价值查 (301名在VA,193名在医疗保险).
- 审查过的退伍军人每100名退伍军人增加了26.7个级联服务,每100名退伍军人增加了2919.4美元的超额成本.
- 护理级联包括进一步的查和门诊访问,几乎没有侵入性手术,跨越VA和医疗保险.
结论:
- 经过低价值的宫癌查后,双重注册的退伍军人经常经历下游护理级联.
- 评估所有医疗保健系统的护理对于了解低价值护理的完整情况至关重要.
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