初级保健实践使用远程医疗和低价值护理服务
Terrence Liu1,2, Ziwei Zhu3, Michael P Thompson4
1Institute for Healthcare Policy and Innovation, Department of Internal Medicine, Veterans Affairs Center for Clinical Management Research (CCMR), Ann Arbor, Michigan.
JAMA network open
|November 7, 2024
概括
在初级保健中,远程医疗的大量使用与低价值的宫癌查和甲状腺检测的减少有关. 这项研究表明,远程医疗可能有助于减少某些浪费性服务,提高护理质量.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 初级医疗保健医学 一级医疗保健医学
- 数字健康数字健康
背景情况:
- 远程医疗的广泛采用已经改变了初级保健的提供,但其对护理质量的影响,特别是对低价值服务的影响,仍然不清楚.
- 人们担心,远程医疗的使用增加可能会导致不必要的医疗保健支出.
研究的目的:
- 调查在初级保健实践中远程医疗使用程度与低价值护理提供率之间的关联.
主要方法:
- 一项回顾性队列研究分析了2019年1月至2022年12月的医疗保险服务费索赔数据.
- 该研究包括与密歇根州初级保健实践有关的医疗保险受益人,并根据远程医疗使用 (低,中,高三级) 分类实践.
- 低价值护理是通过Poisson回归分析的基于办公室,实验室,成像和混合模式服务的8个基于索赔的指标来衡量的.
主要成果:
- 该研究包括2552个初级保健实践中的577,928名受益者.
- 高度使用远程医疗与低值宫癌查和甲状腺测试的比率相比,远程医疗使用率明显较低.
- 远程医疗使用与其他检查的低价值护理服务的费率之间没有发现显著的关联.
结论:
- 采用远程医疗的实践表明,特定的低价值服务的比例减少,包括老年妇女的宫癌查和不必要的甲状腺测试.
- 这些发现表明,远程医疗可以在减轻某些类型的低价值护理方面发挥作用.
- 进一步评估远程医疗对低价值服务的影响对于了解其对医疗保健质量整体影响至关重要.
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