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预先护理计划计费代码与神经疾病中医疗保健利用率下降有关

Gregory Brown, Sol De Jesus, Emily Leboffe

¹Gregory Brown, MD, PhD, Department of Medicine, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania; Sol De Jesus, MD, Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania; Emily Leboffe, MD, Department of Medicine, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania; Andy Esch, MD, Center to Advance Palliative Care, New York, New York; and Kristina Newport, MD, Department of Medicine, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania.

Journal of healthcare management / American College of Healthcare Executives

|January 3, 2025

概括

预先护理规划 (ACP) 代码在神经疾病中使用不足,但与住院和急诊次数较少有关. 记录ACP可以减少慢性神经退行性疾病的医疗保健利用率和经济负担.

科学领域:

老年学是指老年学的学科.
神经学神经学
医疗保健服务研究医疗服务研究

背景情况:

提前护理规划 (ACP) 促进了关于患者护理偏好的讨论.
对于ACP存在补偿代码,但它们在神经疾病中的使用尚未得到充分记录.
慢性神经退行性疾病带来了相当大的医疗保健成本.

研究的目的:

确定在患有慢性神经退行性疾病的患者中,ACP代码的使用与医疗保健的使用之间的关联.
分析入院和急诊室访问在ACP文件之前和之后的趋势.

主要方法:

多中心队列研究使用来自TriNetX数据库的真实世界电子健康数据.
包括65岁以上患有阿尔茨海默病,帕金森病,多发性硬化症或ALS的患者.
在ACP代码和没有ACP代码的患者之间比较住院和ED访问,并分析了ACP前后文档的趋势.

主要成果:

在神经疾病方面,非洲和非洲国家和地区 (ACP) 代码的记录率从1.8%到3.6%不等.
使用ACP代码与阿尔茨海默病患者住院病例显著减少有关.
在所有研究的神经疾病的ACP后文档中观察到ED访问的显著下降20-30%.

结论:

在神经疾病中很少使用ACP账单代码,这表明仅仅补偿是不够的.
非洲国家和地区的使用与减少医疗保健的使用有关,特别是ED访问,可能降低经济负担.
需要进一步的研究,以优化非洲和非洲国家和地区的实施策略,特别是对于像阿尔茨海默氏症这样的普遍疾病.

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