量化德国的低价值护理:使用2018年至2021年法定医疗保险数据的观察性研究
Meik Hildebrandt1, Carolina Pioch2, Lotte Dammertz3
1Department of Health Care Management, Technical University of Berlin, Berlin, Germany; Institute of General Practice and Family Medicine, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany.
低价值的护理,即低收益和高成本的服务,在德国很普遍. 这项研究发现,每年有数百万患者接受这种护理,耗资数百万欧元,突出了对干预的需求.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
- 医疗保健经济学 医疗保健经济学
背景情况:
- 低价值护理,定义为收益不超过成本和潜在危害的服务,是医疗保健系统面临的重大挑战.
- 识别和量化低价值护理对于优化资源配置和改善患者结果至关重要.
研究的目的:
- 估计德国公共卫生保健系统中24个特定的低价值护理服务的流行,分布和相关成本.
- 提供数据,为有针对性的干预提供信息,以减少不必要的医疗服务.
主要方法:
- 一项回顾性观察性研究利用Techniker Krankenkasse (2018-2021) 的法定医疗保险数据,每年覆盖约1110万个人.
- 通过系统审查和专家咨询确定了24个低价值服务指标的流行率计算.
- 应用广泛和狭窄的定义来估计低价值护理的流行率和成本的范围.
主要成果:
- 在2019-2021年期间,160万患者至少获得了一项低价值服务.
- 每年,在1060万项评估服务中,10.4% (广义定义) 和4.0% (狭义定义) 被归类为低价值护理.
- 相关的年度成本约为1550万欧元 (广泛) 和990万欧元 (狭窄).
结论:
- 德国法定医疗保险体系内存在相当多的低价值护理,这是24个研究指标所表明的.
- 这些发现强调了有针对性的干预措施的必要性,以减轻低价值护理.
- 提供了建议,以指导医疗保健政策和实践,以提高德国的质量和患者安全.
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