一种用于识别医疗保险索赔数据中的设施间转移的方法
Sayeh Nikpay1, Michelle Leeberg2, Katy Kozhimannil1
1Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.
一种用于识别医疗保险索赔中的设施间转移 (IFT) 的新方法,使用ST-升高心肌梗塞 (STEMI) 患者,发现转移的数量显著增加. 这种改进的识别更好地代表了农村和低收入人口.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗信息学 医疗信息学
- 心血管医学 心血管医学
背景情况:
- 准确识别设施间转移 (IFT) 对于了解患者护理途径和医疗保健系统内的资源配置至关重要.
- 在大型行政数据集 (如医疗保险索赔) 中识别IFT的现有方法可能是不理想的,可能导致患者人群的不足和错误陈述.
- ST-升高心肌梗塞 (STEMI) 患者往往需要复杂的护理,涉及设施之间的转移,使他们成为评估转移识别方法的相关模型人群.
研究的目的:
- 开发和验证一种用于在医疗保险索赔数据中一致识别设施间转移 (IFT) 的新方法.
- 将拟议的IFT识别方法与现有方法的性能进行比较,使用ST-升高心肌梗塞 (STEMI) 患者队列.
- 用两种方法评估被确定为IFT的患者的人口和地理特征,重点关注农村和低收入人口.
主要方法:
- 使用了100%的医疗保险住院和门诊标准分析档案和5%的载体档案从2011年到2020年.
- 采用观察性,横截面研究设计,将拟议和现有的IFT识别方法之间的患者特征进行比较.
- 分析的重点是65岁及以上的医疗保险受益者被诊断患有STEMI.
主要成果:
- 拟议的方法比现有方法 (86,128对23,460) 发现了62,668个更多的IFT.
- 根据拟议的方法,单独计费的设施间救护车旅行与更高的IFT百分比有关 (86%与79%).
- 通过拟议方法识别的患者更有可能居住在农村和低收入县,并且距离重症监护设施更远 (p < 0.001).
结论:
- 根据两个连续的住院病人的索赔来确定IFT的传统方法导致显著的低估.
- 拟议的方法提供了更全面的IFT识别,更好地反映了农村和服务不足的人口的医疗保健需求.
- 改善IFT识别对于公平的资源分配和理解弱势患者群体的护理准入至关重要.
更多相关视频
04:13Using a Real-Time Locating System to Measure Walking Activity Associated with Wandering Behaviors Among Institutionalized Older Adults
Published on: February 8, 2019
18:11A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
Published on: December 28, 2012
相关概念视频
Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
Health Information Technology and Healthcare Information System
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Integrated Healthcare System
Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
SBAR I: Understanding the Concept
Standardized methods of communication have been developed to ensure that information is...
Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
