按绩效支付计划的早期中断对早期慢性病患者的进展和医疗利用的影响
Yeong-Ruey Chu1, Liang-Yu Chiang2,3,4, Pei-Tseng Kung5,6
1Department of Health Services Administration, China Medical University, No.100, Section 1, Jingmao Road, Beitun District, Taichung, 406040, Taiwan.
概括
打断早期慢性病支付绩效计划 (P4P) 显著增加慢性病患者的风险. 持续参与对于减缓疾病进展和减少医疗保健利用至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 慢性病 (CKD) 管理受益于早期干预计划.
- 台湾的早期CKD绩效支付 (P4P) 计划有效地减缓了CKD的进展.
- 患者中断早期CKD P4P计划的结果需要进一步调查.
研究的目的:
- 为了比较急诊室访问,住院和透析的风险.
- 评估继续与中断早期CKD P4P计划的患者的结果.
主要方法:
- 使用台湾国家健康保险研究数据库进行的回顾性队列研究.
- 包括18岁以上的患者,他们加入了早期CKD P4P计划 (2014-2016年),随访至2021年.
- 使用了倾向得分匹配,日志线性波桑回归和考克斯比例危险模型.
主要成果:
- 分析了100,228名参与者;71,678人被匹配.
- 程序中断与3.41倍更高的急诊次数,3.29倍更高的住院次数和5.46倍更高的透析风险有关.
结论:
- 早期CKD P4P计划的过早中断显著提高了不良健康结果.
- 持续的参与对于管理CKD进展和医疗保健成本至关重要.
- 提高患者在早期CKD P4P计划中的保留率的策略是必不可少的.
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