共享决策与长期坚持肺癌查的关联
YoonKyung Chung1, Chi-Mei Liu1, Elizabeth Y Rula1
1Harvey L. Neiman Health Policy Institute, Reston, Virginia.
Chest
|July 11, 2025
概括
在初始肺癌查 (LCS) 之前的共享决策 (SDM) 访问显著提高了医疗保险受益人对年度查的坚持. 这一战略在四年内将查率提高了高达32.5%.
科学领域:
- 肺部医学 肺部医学
- 医疗保健服务研究 医疗服务研究
- 预防性心脏病学 预防性心脏病学
背景情况:
- 使用低剂量计算机断层扫描 (LDCT) 的肺癌查 (LCS) 降低了死亡率,但在符合条件的医疗保险受益者中,其遵守率很低.
- 医疗保险要求在初始LCS访问之前进行共享决策 (SDM),旨在改善遵守,尽管其长期影响尚不清楚.
研究的目的:
- 为了确定SDM在初始LCS之前的访问是否与医疗保险受益人随着时间的推移改善了查遵守.
- 评估SDM访问对每年LCS遵守的持续影响.
主要方法:
- 追溯队列研究利用医疗保险服务费索赔数据从2016-2019年.
- 在初始LCS之前90天内访问SDM的受益人与没有访问SDM的受益人进行比较.
- 线性概率模型用于估计年查率的差异,用于初始查后1-4年,控制共变量.
主要成果:
- 在22670名接受查的受益人中,11.4%的受益人之前曾访问过SDM.
- 与非SDM组相比,SDM组在LCS后的第一年表现出比非SDM组高26.5%的坚持率.
- 这种依附优势持续存在,并在四年内增加到32.5%以上.
结论:
- 共享决策访问与高达四年的肺癌查遵守率显著增加有关.
- SDM访问是提高医疗保险人口中LCS遵守率的可行策略.
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