认知障碍和没有认知障碍的个体利用低价值和高价值的医疗保健
Douglas Barthold1, Shangqing Jiang, Anirban Basu
1The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, University of Washington, 1959 NE Pacific St, Box 357630, Seattle, WA 98195.
The American journal of managed care
|July 12, 2024
概括
包括痴呆症在内的认知能力下降的老年人接受的高价值护理较少,例如降血糖药物和他类药物. 低价值的护理与认知状态没有一致的联系,突出了更好的护理质量错失的机会.
科学领域:
- 老年学是指老年学的学科.
- 医疗保健服务研究 医疗服务研究
- 认知神经学 认知神经学
背景情况:
- 认知障碍和痴呆症在老年人中越来越普遍.
- 这些情况会影响医疗保健的利用率和患者的治疗结果.
- 了解这一群体的医疗保健价值至关重要,但有限.
研究的目的:
- 评估老年人接受低价值 (LV) 和高价值 (HV) 的医疗保健服务.
- 在那些有正常认知,没有痴呆症的认知障碍 (CIND) 和痴呆症的人中比较医疗保健价值.
主要方法:
- 使用与医疗保险索赔相关的健康和退休研究数据 (1996-2018) 的回顾性队列研究.
- 研究了认知衰退与接受5种LV和7种HV服务之间的关联.
- 对比了认知变化和没有认知变化的个体.
主要成果:
- 在所有认知状态中,低价值护理收到率从4%到13%不等.
- 认知能力下降与接受一项LV服务 (老年人结肠直肠癌查) 的减少有关.
- 认知衰退显著减少了三种HV服务的接收:降血糖药物,他类药物和抗吸收疗法.
结论:
- 低价值的护理并不始终与认知状态相关,尽管存在潜在的危害.
- 认知障碍者接受高价值护理的减少代表了错过的机会.
- 研究结果表明,所有老年人,包括认知障碍者,都有改善质量的机会.
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