在一个学术医院,尽管增加了资源配置,但强制性患者报告结果率不足
Robert A Burnett1, Brenna Blackburn1, Michael J Archibeck1
1Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah.
根据患者报告的基于结果的绩效指标 (PRO-PMs) 的符合性在选择性关节整形患者中很低. 文字提醒提高了PRO-PM收集率,但任务可能是繁重的.
科学领域:
- 整形外科手术 整形外科手术
- 卫生政策 卫生政策
- 医疗信息学 医疗信息学
背景情况:
- 新的医疗保险和医疗补助服务中心 (CMS) 任务要求50%的患者报告的基于结果的绩效指标 (PRO-PMs) 在选择性关节整形中符合要求.
- 合规对于医疗保险的服务费偿还和质量评估至关重要.
研究的目的:
- 在CMS任务截止日期之前评估一个机构的PRO-PM捕获率.
- 识别与PRO-PM数据收集不合规相关的风险因素.
主要方法:
- 对2692名接受部和膝关节关节整形手术 (2021-2022) 的患者进行了回顾性分析.
- 数据收集包括人口统计信息和手术前后窗口的PRO-PM合规性.
- 在实施基于文本的PRO-PM收集服务后,对合规性变化的分析.
- 多变量分析以确定不合规的独立风险因素.
主要成果:
- 整体遵守率很低:手术前49.1%,手术后25.8%.
- 术前和术后的PRO-PM合并遵守率仅为14.1%.
- 引入文本提醒使双重合规率从7.9%增加到19.6%.
- 不遵守规定的风险因素包括非英语主要语言,较高的并发症负担和缺乏文本提醒.
结论:
- 目前的CMS对PRO-PM收集的授权可能过于繁重,即使在学术机构的遵守率也很低.
- 专注于患者参与的举措,如基于文本的提醒,可以显著提高PRO-PM收集率.
- 需要进一步的战略来优化患者参与,并实现合规目标.
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