基于社区的多领域预防性健康计划对新加坡老年人医疗保健利用的影响:一个倾向性得分匹配和差异差异研究
Francis Phng1, Adrian Ujin Yap2,3, Wesley Teo4
1Health Services Research & Analytics, Ng Teng Fong General Hospital, Singapore francis_phng@nuhs.edu.sg.
BMJ open
|October 2, 2024
概括
使用社区卫生工作者 (CHW) 的"我的健康地图" (MHM) 计划,显著减少了老年人的急诊室访问和住院. 这表明CHW在老龄化人口的预防性医疗保健中是有效的.
科学领域:
- 老年学与公共卫生
- 预防医学 预防医学
- 医疗保健管理的管理
背景情况:
- 人口老龄化对全球医疗保健系统构成重大挑战.
- 社区卫生工作者 (CHW) 的干预越来越被认为有助于促进健康老龄化和管理非传染性疾病.
- 我的健康地图 (MHM) 计划是一个多领域的倡议,旨在应对这些挑战.
研究的目的:
- 评估由医疗保健中心提供的MHM计划对老年人使用医疗服务的影响.
- 评估MHM干预后急诊室 (ED) 使用率和住院人数的变化.
- 利用倾向性得分匹配方法来进行可靠的影响评估.
主要方法:
- 卫生保健计划包括查,疫苗接种,慢性疾病管理,咨询和社会环境干预.
- 参与MHM计划的40岁及以上年龄组 (干预组) 与1:1倾向匹配的对照组进行了比较.
- 结果 (ED出席率,住院病例) 用基线和1年随访的差异差异估计来分析.
主要成果:
- 建立了一个由299名参与者和299名对照组组成的匹配比较组,没有显著的基线差异.
- MHM干预组显示ED出席率的统计显著下降 (-16.7%,p<0.001).
- 与对照组相比,干预参与者 (-18.4%,p<0.001) 的住院病例也显著下降.
结论:
- 多领域的MHM计划有效地减少了老年人的急诊室出院和住院.
- 社区卫生工作者 (CHWs) 是医疗保健服务中宝贵的变革推动者.
- 建议将CHW系统地纳入预防性健康策略,以改善老龄化人口的结果.
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