通过全州协作医院倡议改善周边插入中央导管的适当使用:成本效益分析
概括
一个质量改进计划激励适当的外围插入中央导管 (PICC) 使用显著减少了像CLABSI和VTE这样的并发症. 这一举措通过避免医疗保健成本,显示出了大量的投资回报,并证明了医院的成本效益.
科学领域:
- 医疗保健经济学 医疗保健经济学
- 提高质量 提高科学 提高质量
- 感染控制 感染控制
背景情况:
- 质量改进 (QI) 计划需要大量的财务投资.
- 评估由医生主导,绩效激励的QI干预措施的成本效益对于医疗保健的可持续性至关重要.
研究的目的:
- 评估QI干预措施的经济影响,旨在增加适当的外围插入中心导管 (PICC) 使用.
- 通过大规模的QI计划来确定减少PICC相关并发症的成本效益.
主要方法:
- 从医疗保健部门的角度进行经济评估,包括实施成本 (激励,数据抽象,协调).
- 倾向性得分匹配分析,比较预防干预 (2015-2016) 和干预 (2017-2021) 期间的并发症率 (VTE,CLABSI,闭塞).
- 成本效益表达为每次避免并发症的成本抵消.
主要成果:
- 显著减少了PICC并发症:CLABSI (2.1%至1.5%),VTE (3.2%至2.3%) 和导管封闭 (10.8%至7.0%).
- 估计有871个CLABSI,2535个VTE和8743个导管封闭被预防.
- 项目成本为3180万美元,避免并发症的成本抵消为6440万美元,在七年内平均医院成本抵消为932073美元.
结论:
- 一个大规模的,多医院的QI倡议,针对适当的PICC使用,证明了显著的成本效益.
- 该干预措施通过抵消预防并发症的成本抵消,产生了大量的投资回报.
- 医生主导的,以绩效为激励的QI计划可以在医疗保健环境中从经济上获益.
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