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在医疗保险基于价值的计划中,通过药剂师综合护理减少再入院
Dor Partosh1, Lazara Cabrera Ricabal2, Diana C Beltran2
1Department of Pharmacy, Memorial Healthcare System, Miramar, FL, USA.
概括
药房转换护理 (ToC) 和人口健康服务显著减少了医疗保险患者的90天再入院. 这些发现支持扩大药剂师主导的干预措施,以改善患者的长期结果.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床药房 临床药房
- 人口健康管理 人口健康管理
背景情况:
- 众所周知,药房的护理过渡 (ToC) 计划可以减少30天的再入院.
- 有限的数据存在于药剂师集成的ToC服务超过30天的长期影响.
- 医疗保险以价值为基础的计划 (MV-BPs) 鼓励减少再接收.
研究的目的:
- 评估药剂师集成的ToC和人口健康服务对医疗保险基于价值计划 (MV-BP) 人群中30日,60日和90天所有原因的再入院的影响.
- 为了比较第一次再入院的平均时间,有和没有药剂师护理.
主要方法:
- 对医院出院遭遇 (DE) 的回顾性观察图表审查.
- 在MV-BP中,患者 (≥18岁) 被分配到对照组或基于所收到的药房 ToC 服务的三个干预组之一.
- 服务由住院的ToC药剂师或专业的人口健康药剂师 (PHP) 提供.
主要成果:
- 在90天随访的1,039名患者中,对照组的再入院率为34.74%.
- 与对照组相比,干预组2和3的90天再接收率明显较低 (分别为9.57%和17.07%).
- 干预组1没有显示90天再接收的显著减少 (29.85%).
结论:
- ToC和PHP服务的结合有效地降低了MV-BP人口中的30日,60日和90日再接收率.
- 这些发现凸显了综合药房服务在尽量减少长期再入院的好处.
- 建议为这种医疗保险人群扩大以药房为基础的 ToC 服务.
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