捆绑支付影响了对所规定的家庭医疗保健的采用
1Maxwell School of Citizenship and Public Affairs, Syracuse University, 314 Lyman Hall, Room 320E, Syracuse, NY 13244.
The American journal of managed care
|February 20, 2025
概括
综合关节置换护理 (CJR) 模型略有减少了手术后家庭医疗保健 (HHC) 使用的下降,特别是在白人患者中. 需要进一步努力,以改善跨不同患者群体的HHC吸收.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健政策 医疗保健政策
- 整形外科手术的结果
背景情况:
- 关节置换综合护理 (CJR) 模式的实施是为了激励主要关节置换手术的协调和高效护理.
- 了解这些模型对手术后护理途径的影响,如家庭医疗保健 (HHC) 的利用,对于评估它们的有效性至关重要.
研究的目的:
- 调查CJR模型是否影响了接受重大关节置换手术的患者接受家庭医疗保健 (HHC) 的情况.
- 评估CJR模型对各种种族和种族群体的HC吸收的影响.
主要方法:
- 使用差异差异队列研究设计,将CJR指定地区的医院与对照医院进行比较.
- 主要结局是病例组合调整后的医院级HHC吸收率,定义为在出院14天内接受HHC访问.
- 二次结果包括种族/种族的HHC吸收率和使用的HHC机构的质量.
主要成果:
- 在全国范围内,HC的吸收在CJR实施后下降. 然而,与对照医院相比,CJR医院的下降幅度较小 (3.73个百分点).
- 这种缓解HHC摄入量下降的主要原因是白人患者. 在黑人患者中观察到微小显著的差异性增加.
- 在西班牙裔或亚裔美国人/太平洋岛民人群中,没有发现HHC摄入量的显著变化,HHC质量也没有显著改善.
结论:
- 该CJR模型部分抵消了全国HHC吸收率下降的趋势,表明对护理协调的潜在好处.
- 虽然该模型在缓解差异方面显示出一些前景,但需要进一步的干预,以提高更广泛的患者人口统计学中的HHC吸收率.
相关概念视频
01:29Documentation in Long-Term and Home Healthcare Setting
868
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
868
01:18Introduction To Health Care Delivery System
2.6K
The healthcare system is constantly changing and complex. Various services are available from different healthcare providers, but gaining access to these services has become challenging for people with limited healthcare insurance. Uninsured people present a challenge to healthcare because they frequently postpone or forego treatment.
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
2.6K
01:29Issues And Trends In Healthcare Delivery System
5.6K
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
5.6K
01:15Methods of Documentation VI: Case Management Model
559
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
559
01:26Methods Of Healthcare Delivery System
3.1K
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
3.1K
01:30Health Information Technology and Healthcare Information System
790
Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
790