短期收益,持久潜力:一个集成的SDOH专注护理模式可以节省成本和患者报告的好处
Sasha Ruben Sioni1, Lesley Manson1, Nicholas Arledge2
1College of Health Solutions, Arizona State University, Phoenix, Arizona, USA.
Population health management
|March 28, 2025
概括
一个为高需要,高成本的成年人提供综合护理的模式显著减少了急诊室的访问和住院. 这种方法也节省了大量的成本,提高了患者的满意度,证明了人口健康管理的价值.
科学领域:
- 医疗保健管理的管理
- 人口健康 人口健康
- 健康 公平 卫生 公平
背景情况:
- 高需要,高成本 (HNHC) 人群需要综合护理,解决临床需求和健康的社会决定因素 (SDOH).
- 现有的护理模式往往无法全面管理HNHC成年人,导致高医疗利用率和成本.
- 需要有效的战略来改善这一弱势群体的结果,并减少对这一弱势群体的支出.
研究的目的:
- 评估城市初级保健机构中HNHC成年人综合护理模式.
- 评估干预对急性医疗保健利用,成本和患者报告结果的影响.
- 确定结果中的潜在差异,并为以公平为重点的战略提供信息.
主要方法:
- 在四个城市初级保健诊所对526名HNHC成年人进行了回顾性,倾向性得分匹配的研究.
- 干预包括每月SDOH查,药物监督和实时入院-出院-转移 (ADT) 警报.
- 与通常的护理进行比较,以确定模型的有效性.
主要成果:
- 该干预措施在60天内显著减少了急诊室 (ED) 访问量0.17 (P < 0.001) 和住院人数0.12 (P < 0.001).
- 每位参与者的总成本减少了3,597美元,净储蓄为3,222美元 (P < 0.001),投资回报率为6.9:1.
- EQ-5D-5L得分提高了0.082 (P < 0.001) 和净促销商得分上升了8.8分 (P < 0.001).
结论:
- 综合护理模式有效地减少了急性利用率,并为HNHC成年人带来了显著的成本节省.
- 该模型改善了患者报告的生活质量和满意度,与基于价值的护理目标保持一致.
- 需要文化定制的方法来解决非白人队列中观察到的较小的生活质量增长问题,并推进健康公平.
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