对于患有多发性硬化症的人群中观察到的直接医疗利用趋势,包括远程神经神经病学使用者和各种人群中
Kaitlyn N Palmer1, Daniel Ontaneda1, Tucker Harvey2
1Mellen Center for Multiple Sclerosis, Cleveland Clinic, Cleveland, OH, USA.
概括
在多发性硬化症 (MS) 护理中使用神经神经元学增加了访问量,但减少了实验室和MRI订单. 紧急医疗利用率保持不变,这表明没有增加HCU的整合潜力.
科学领域:
- 神经学 神经学
- 医疗保健服务研究 医疗服务研究
- 数字健康数字健康
背景情况:
- 电神经病对多发性硬化症 (MS) 患者的医疗利用 (HCU) 的影响仍然在很大程度上是未知的.
- 了解电神经病对HCU的影响对于优化护理交付模式至关重要.
研究的目的:
- 评估MS和临床隔离综合征 (CIS) 患者中电神经学和医疗保健利用之间的关联.
- 为了确定电神经学是否影响实验室,MRI订单和急诊.
主要方法:
- 对成年多发性硬化和CIS患者的HCU数据进行了回顾性纵向分析 (2020年7月至2022年7月).
- 负二项回归模型被用来评估电脑神经病比例与HCU指标之间的关系.
- 分析包括实验室订单,MRI订单,以及每位患者的急诊.
主要成果:
- 使用电神经治疗的患者的诊断次数显著增加 (RR 1.707-1.719,p < 0.001).
- 电脑神经病诊所访问与较少的实验室 (RR 0.571) 和MRI订单 (RR 0.693,p < 0.001) 有关.
- 对于电神经病患者 (p >= 0.05) 紧急护理利用率没有发现显著差异.
- 黑人和医疗补助患者的紧急诊所访问率更高,无论访问类型如何 (p < 0.001).
结论:
- 将电神经病学整合到医疗保健模型中可能不会增加与访问相关的利用率,如订单减少所证明的那样.
- 虽然远程神经系统增加了总体的访问量,但它并没有提高紧急医疗保健的利用率.
- 需要进行进一步的研究,以确定电神经病对整体HCU的长期影响,特别是对风险人群的长期影响.
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