通过人工智能和自动化减少安全网中的再接收
Daniel J Bennett, Jean Feng, Seth Goldman
1Zuckerberg San Francisco General Hospital, 1001 Potrero Ave, Room 5G2, San Francisco, CA 94110.
The American journal of managed care
|March 7, 2025
概括
一项新技术倡议显著减少了重返医院的住院数量,并消除了安全网医疗系统中的种族差异. 这种方法改善了患者的生存率和财务表现,为基于价值的护理提供了一个模型.
科学领域:
- 医疗信息学 医疗信息学
- 人口健康管理 人口健康管理
- 健康 公平 卫生 公平
背景情况:
- 住院再接收是一个重大挑战,特别是在安全网医疗系统.
- 减少再接收对于改善患者的治疗结果和财务可持续性至关重要.
- 现有的再接收减少策略往往需要通过技术进行增强,以获得更大的影响.
研究的目的:
- 实施和评估一项以技术为导向的倡议,旨在减少医院再入院.
- 评估倡议对临床结果,护理公平和财务绩效的影响.
- 确定该模型对其他资源有限的医疗保健机构的可行性.
主要方法:
- 从2015年10月到2023年1月进行了回顾性中断时间序列分析.
- 一个电子健康记录集成的,自动化决策支持工具标准化住院护理.
- 一个预测性人工智能算法识别了高风险患者进行主动门诊管理.
主要成果:
- 再录取率从27.9%下降到23.9% (P <.004). 在美国,再录取率从27.9%下降到23.9% (P <.004).
- 消除了黑人/非裔美国患者再入院率的差异.
- 全因死亡率降低 (HR,0.82;P = .037),该系统保留了720万美元的资金.
结论:
- 这项以技术为基础的倡议有效地减少了 readmissions,改善了公平,并在安全网系统中提高了生存率.
- 该模型展示了技术驱动,基于价值的护理在资源有限的环境中的潜力.
- 该方法成功满足了绩效支付指标,同时改善了患者护理和财务稳定.
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