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基于价值的评估,通过使用成本和结果数据重新设计妊娠糖尿病治疗途径
Maud van den Berg1, Julia Spaan2, Jacoba van der Kooy3
1Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, Rotterdam, 3062 PA, The Netherlands. vandenberg@eshpm.eur.nl.
BMC pregnancy and childbirth
|May 26, 2025
概括
重新设计妊娠糖尿病 (GDM) 护理改善了患者体验,降低了成本,但没有改变临床结果. 这种以价值为基础的医疗保健方法优化了怀孕期间的GDM管理.
科学领域:
- 孕产妇健康 孕产妇健康
- 医疗保健管理的管理
- 基于价值的医疗保健
背景情况:
- 孕期糖尿病 (GDM) 是一种常见的妊娠并发症,需要改善护理.
- 传统的GDM护理是分散的,需要基于价值的医疗保健 (VBHC) 的实施.
- 重新设计护理途径和支付模式可以提高GDM护理的价值.
研究的目的:
- 评估重新设计的GDM护理途径的基于价值的影响.
- 评估临床结果的变化,患者经验和护理重新设计后的成本.
- 确定将GDM护理从内科转移到综合产妇护理的有效性.
主要方法:
- 前性,观察性队列研究,比较干预前后组 (2021年与2022年).
- 从内部医学部门 (IMD) 转移到综合产妇保健组织 (IMCO).
- 评估的临床结果,患者报告的经验 (响应性问卷) 和成本 (基于时间驱动的活动成本).
主要成果:
- 对GDM进行IMD的转诊减少了84.8%;患者体验显著改善.
- 开始胰岛素治疗的人数减少了46.8%;母亲和新生儿的结局保持不变.
- 干预后每次GDM治疗的加权平均成本降低了9.7%.
结论:
- 通过减少转诊和改善患者体验来重新设计GDM护理增强价值,以保持稳定的临床结果.
- 减少GDM护理的碎片化导致了显著的成本节约.
- 通过对重新设计倡议的全面评估,促进在产妇护理中采用VBHC.
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