药物坚持星级评级措施,医疗保健资源利用率和成本
Insiya B Poonawalla1, Linda Chung, Sarah Shetler
1Humana Healthcare Research, Inc, 500 W Main St, Louisville, KY 40202.
The American journal of managed care
|May 15, 2024
概括
缺少药物坚持措施,特别是对于糖尿病,高血压和高脂血症,与更高的医疗保健使用和成本有关. 改善遵守规则可以减少住院,紧急诊所和整体医疗费用.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 药物经济学 药物经济学
- 提高医疗保健的质量 改善医疗保健的质量
背景情况:
- 医疗保险星级评级通过遵守措施激励优质护理.
- 药物不服药会影响患者的治疗结果和医疗费用.
- 了解依从性测量绩效与资源利用之间的联系对于基于价值的护理至关重要.
研究的目的:
- 为了调查错过的医疗保险和医疗补助服务中心 (CMS) 星级评级质量指标在三年内对药物坚持的关联.
- 分析糖尿病,高血压和高脂血症药物的不坚持以及随后的医疗保健利用和成本之间的关系.
主要方法:
- 对103,900名医疗保险优势计划的登记者进行了回顾性队列研究.
- 患者根据三年内错过的药物坚持测量次数 (0,1,2,3,4+) 分类为组.
- 分析住院住院,急诊室访问和每月的医疗费用.
主要成果:
- 缺乏遵守措施与所有原因和与糖尿病相关的住院住院和紧急诊所的风险增加有关.
- 缺少1,2,3或4+的坚持措施的患者每月医疗费用分别增加了14%,19%和20%.
- 观察到医疗保健利用率和成本的增加,即使仅缺少一个遵守措施.
结论:
- 未能满足CMS星级评级对药物坚持的质量指标与更大的医疗保健资源利用有关.
- 不坚持治疗糖尿病,高血压和高脂血症等慢性疾病的药物导致医疗保健成本显著上升.
- 针对改善药物坚持的干预措施可能会降低医疗保健支出并改善患者的治疗结果.
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