与记录的护理目标相关的与成本相关的结果 谈话
Gina M Piscitello1, Robert M Arnold2, Jane Schell1
1Division of General Internal Medicine, Section of Palliative Care and Medical Ethics (G.M.P., J.S.), University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Palliative Research Center, University of Pittsburgh (G.M.P., J.S.), Pittsburgh, Pennsylvania, USA.
早期记录的护理对话目标 (GOCC) 与专业息咨询 (SPC) 显著降低了医院费用和死亡率. 这凸显了GOCC及时融入患者护理中的财务和临床好处.
科学领域:
- 卫生经济学 卫生经济学
- 抚慰性护理是一种缓解性护理.
- 医疗保健管理的管理
背景情况:
- 对于在住院患者中记录的护理对话目标 (GOCC) 和与成本相关的结果之间的联系的理解有限.
- 调查GOCC对医疗保健支出的影响对于资源优化至关重要.
研究的目的:
- 评估记录的GOCC与专业息咨询 (SPC) 和医院成本相关结果的关联.
- 确定早期GOCC对患者治疗结果和医疗保健成本的影响.
主要方法:
- 在2022年至2024年期间住院的成年患者的多医院,横截面研究.
- 使用倾向得分匹配和多变量逻辑/线性回归模型.
- 分析了来自267,375名患者的数据,匹配的队列为24,600.
主要成果:
- 记录有SPC的GOCC与减少住院死亡,30天再入院和更短的住院时间相关.
- 早期使用SPC的GOCC (48小时内) 显示,直接医院总费用显著降低.
- 相反,没有SPC的总体记录的GOCC与增加的死亡率,更长的住院时间和更高的成本有关.
结论:
- 早期记录的GOCC,特别是与SPC结合使用时,与改善患者的治疗结果和降低与成本相关的治疗结果有关.
- 及时整合GOCC可能会导致医院大幅节省成本.
- 这些发现强调了在管理医疗保健成本方面,主动讨论护理目标的价值.
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