更好的护理,相同的成本 - 减少多次访问患者的计划外护理:支付者-提供者模式
Janel Hanmer1, Yushu Liu2, Anita Leon-Jhong3
1Department of General Internal Medicine, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA, 15213, USA. hanmerjz@upmc.edu.
Journal of general internal medicine
|September 3, 2024
概括
增强护理计划 (ECP) 显著减少了多次访问患者 (MVP) 的计划外护理. 虽然ECP降低了急诊室和住院费用,但总体成本与对照组相似.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健管理的管理
- 患者的治疗结果.
背景情况:
- 多次访问患者 (MVP) 经常需要干预措施来解决以患者为中心的需求,并减少 ambulatory-sensitive 条件的无计划护理.
- 现有的研究需要更深入地了解干预措施如何影响护理利用,特别是计划外护理事件.
研究的目的:
- 评估增强护理计划 (ECP) 的影响,这是一个合作的付款人-提供者模式,对计划外护理的利用.
- 评估ECP对高需要患者群体护理总体成本的影响.
主要方法:
- 使用保险公司会员档案构建了一个倾向分数匹配的比较组.
- 使用差异差异分析来比较ECP干预组 (n=357) 和对照组之间的结果.
- ECP涉及高强度门诊干预,包括家庭访问和密集护理协调,用于具有高历史医疗保健利用率的患者.
主要成果:
- 总体而言,在ECP组中,非计划性护理遇到的情况每年每100名成员减少320人 (p <0.05).
- 经过ECP,与非计划的急诊室访问,观察入院和住院患者行为健康入院相关的成本有显著的统计降低.
- 虽然药房和实验室费用增加,但ECP组的护理总费用与对照组在统计上没有差异 (p = 0.55).
结论:
- 增强护理计划 (ECP) 有效地减少了多次访问患者的计划外护理利用率.
- ECP代表了一种可行的干预模式,用于管理高利用率患者群体,并减轻特定类型的计划外医疗保健成本.
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