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药房参与对管理医疗补助病人的护理差距缩小的影响
Ellen Montgomery1, Tiffany Sherod-Harris1, Marina Adkins1
1Department of Pharmacy, Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA.
概括
药房团队的参与显著改善了管理医疗补助计划患者的护理缺口. 药剂师的建议增加了填补差距的可能性,特别是在糖化血红蛋白 (HbA1c) 和血压 (BP) 测量方面.
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:
- 基于价值的护理模式需要积极的患者管理.
- 管理的医疗补助计划旨在改善弱势群体的健康结果.
- 缩小护理差距是评估医疗保健系统护理质量的关键指标.
研究的目的:
- 评估人口健康药房团队对管理医疗补助患者的护理缺口关闭的影响.
- 评估药剂师干预措施在提高对质量措施的遵守方面的有效性.
- 确定药房参与与填补特定护理缺口之间的关联.
主要方法:
- 管理医疗补助计划患者的回顾性队列研究,药房风险得分高.
- 对干预组 (药房审查的患者) 与对照组 (药房未审查的患者) 的比较.
- 主要结果:到2022年底,至少关闭一个护理缺口 (HbA1c或BP). 二次结果:填补差距的数量,药剂师推的频率和提供者实施.
主要成果:
- 药房干预与关闭至少一个护理差距的可能性显著增加 (74%对50%,OR 2.85,P=0.032).
- 在干预组中,糖化血红蛋白 (HbA1c) 缺口的缩小更频繁 (60%对27%).
- 药剂师推的频率与差距的弥补相关 (P=0.012),无论提供商的实施频率如何.
结论:
- 药房团队的参与显著提高了管理医疗补助计划患者的护理缺口关闭率.
- 药剂师的建议是改善质量衡量的关键驱动力.
- 将药房服务纳入人口健康战略可以优化患者的治疗结果和基于价值的护理绩效.
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