在医疗保险中诊断出阿尔茨海默病和相关痴呆症的病例定义
Kan Z Gianattasio1, Jason Wachsmuth1, Ryan Murphy1
1NORC at the University of Chicago, Bethesda, Maryland.
JAMA network open
|September 3, 2024
概括
美国缺乏痴呆症监测,阻碍了对阿尔茨海默病和相关痴呆症 (ADRD) 的支持. 这项研究使用ICD-10-CM和药物代码开发了病例定义,以确定2019年超过540万名可能患有ADRD的医疗保险受益人.
科学领域:
- 公共卫生监督 公共卫生监督
- 老年医学 老年医学
- 医疗信息学 医疗信息学
背景情况:
- 美国国家对阿尔茨海默氏症和相关痴呆症 (ADRD) 的监测系统存在重大差距.
- 这种缺陷阻碍了支持ADRD患者和解决健康差异的努力.
研究的目的:
- 审查诊断和处方药代码,以识别行政数据中的ADRD.
- 制定和实施国家ADRD监控系统的案例定义.
主要方法:
- 进行了系统的文献审查,以确定国际疾病统计分类,第十次修订,临床修改 (ICD-10-CM) 和ADRD的处方药代码.
- 基于代码频率,受益人特征和专家共识,开发了案例定义 (极有可能,可能,可能的ADRD).
- 将这些定义应用于2017-2019年医疗保险服务费用 (FFS) 和医疗保险优势 (MA) 数据,以分类2019年医疗保险入学者.
主要成果:
- 在2019年确定了超过800万名医疗保险受益者,至少有可能的ADRD证据.
- 超过540万受益人符合可能或极可能出现ADRD的标准.
- 有ADRD证据的受益人比没有ADRD证据的受益人更老,更脆弱,更有可能是女性,双重资格,使用长期护理,并且与没有ADRD证据的受益人相比,医疗保健支出更高.
结论:
- 使用ICD-10-CM和药物代码开发的诊断病例定义可以暂时用于国家ADRD监测.
- 这种方法确定了大量的医疗保险受益者患有ADRD,突出了监测的必要性.
- 建议对临床和其他确定方法进行进一步验证.
相关概念视频
01:26Alzheimer's Disease: Overview
454
Alzheimer's Disease (AD) is a continually advancing neurodegenerative disorder, distinguished by escalating memory loss, cognitive dysfunction, and dementia. The disease unfolds in three stages: preclinical, mild cognitive impairment (MCI), and dementia. Its onset is insidious, and the progression gradual, with the cause not well explained by other disorders.
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
454
01:30Dementia
107
Dementia is a collective term for cognitive disorders primarily affecting memory, thinking, and reasoning. It is not a specific disease but a syndrome, with Alzheimer's disease being the most common cause, accounting for approximately 60-80% of cases. Other types include vascular dementia, Lewy body dementia, and frontotemporal dementia. Dementia affects millions worldwide, particularly older adults, though it is not a normal part of aging.
The progression of dementia is generally gradual....
The progression of dementia is generally gradual....
107
01:22Alzheimer's Disease: Treatment
170
Alzheimer's Disease (AD), a neurodegenerative disorder, is pathologically identified by amyloid plaques and neurofibrillary tangles composed of tau protein. AD pharmacotherapy aims to manage cognitive symptoms, delay disease progression, and treat behavioral symptoms. The treatment is primarily symptomatic and palliative, with no definitive disease-modifying therapy available. Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), are...
170
01:29Documentation in Long-Term and Home Healthcare Setting
875
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
875
01:15Methods of Documentation VI: Case Management Model
564
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
564
01:25Formulating and Validating Nursing Diagnosis II
2.7K
Nursing diagnoses represent a problem validated by major defining characteristics. There are four categories of nursing diagnoses: problem-focused, risk, health promotion or wellness, and syndrome. The anatomy of a nursing diagnosis includes three components: problem statement or diagnostic label, defining characteristics, and related factors.
Risk nursing diagnoses represent clinical judgments of an individual, family, or community more vulnerable to developing the health problem than others...
Risk nursing diagnoses represent clinical judgments of an individual, family, or community more vulnerable to developing the health problem than others...
2.7K