对慢性护理管理模式的评估,以提高效率和财政可持续性
Margaret A Kadree1, Patrick Wiggins1, Lura Thompson1
1Margaret A. Kadree is with the Johnson Federally Qualified Health Center, Lynchburg, VA. Margaret A. Kadree and Patrick Wiggins are with the Division of Prevention and Health Promotion, Virginia Department of Health, Richmond. Lura Thompson is with Care Connexion Rx Richmond, Richmond. Cynthia Warriner and Michelle White are with Health Quality Innovators, Richmond.
一个扩大的慢性护理管理团队改善了2型糖尿病和高血压患者的健康结果. 这个模型显示出财政可行性,医疗保险退款率为85.5%.
科学领域:
- 公共卫生 公共卫生
- 医疗保健管理的管理
- 慢性疾病管理 慢性疾病管理
背景情况:
- 慢性护理管理 (CCM) 计划面临的挑战是提供者负担和财务可持续性.
- 传统的CCM通常依赖于有限的供应商-护士对象来完成劳动密集型任务.
- 开发持久有效的CCM模型对于管理慢性疾病至关重要.
研究的目的:
- 评估在门诊环境中扩大慢性护理管理团队的有效性.
- 评估多学科团队对患者健康结果和提供者工作量的影响.
- 通过医疗保险报销率来确定扩展的CCM模型的财政可持续性.
主要方法:
- 一个扩大的CCM团队 (提供者,护士,社区卫生工作者,药剂师) 实施了为期四个月的干预.
- 134名没有控制的2型糖尿病或高血压的医疗保险患者的方便样本参与了这项研究.
- 监测了关键的健康指标 (糖尿病控制,血压) 和提供者工作量.
主要成果:
- 在2型糖尿病控制中观察到统计学上显著的改善 (P < .01).
- 血压得到显著降低 (P < .001).
- 直接提供者的工作量减少,医疗保险退款率达到85.5%.
结论:
- 一个扩大的,多学科的慢性护理管理团队可以有效地改善2型糖尿病和高血压患者的治疗结果.
- 这种模型表明了财政可持续性和 ambulatory care 环境中减少提供者负担的潜力.
- 实施综合护理团队是加强慢性疾病管理的可行策略.
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