远程医疗的采用和低价值护理的使用和支出在收费医疗保险的受益者
Ishani Ganguli1,2,3, Christopher Lim1, Nicholas Daley2
1Harvard University, Boston, Massachusetts.
JAMA internal medicine
|February 24, 2025
概括
远程医疗的采用与医疗保险受益人中20项低值测试中的7项略有下降有关. 这表明远程医疗的潜在好处,减轻了人们对医疗保健支出增加的担忧.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 数字健康数字健康
- 卫生经济学 卫生经济学
背景情况:
- 低价值护理在医疗保健提供中存在重大挑战,导致患者直接和间接受到伤害.
- 远程医疗在医疗保健中的作用正在扩大,其潜在影响包括减少和增加低价值测试.
研究的目的:
- 调查卫生系统采用远程医疗与Medicare收费服务受益者使用低价值测试之间的联系.
- 量化远程医疗对特定类型低价值测试和整体医疗保健利用和支出的影响.
主要方法:
- 一个队列研究利用100%的费用服务医疗保险索赔数据从2019-2022.
- 根据2020年远程医疗的采用情况,卫生系统被分为四分之一.
- 差异分析比较了高远程医疗采用系统 (上四分位数) 和低远程医疗采用系统 (下四分位数) 的受益人,关于低值测试使用和访问结果.
主要成果:
- 高远程医疗系统的受益人显示,总访问量略有增加,但在20项检查的低值测试中,使用7项测试的差异性减少,包括宫癌查,查心电图和腰部疼痛成像.
- 在使用其他低值测试时没有观察到统计学上显著的差异.
- 在高远程医疗系统中,每个受益人的访问支出大幅下降,而低价值支出总体上没有增加.
结论:
- 远程医疗的采用与某些低价值测试的使用量略有减少有关,特别是护理点测试.
- 调查结果表明,远程医疗在制低价值护理方面具有潜在的好处,并且不支持人们担心它会大大增加医疗保健支出.
- 进一步的研究可以探索远程医疗影响测试模式和患者结果的机制.
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