在医疗保险D部分的综合药物审查后,医疗保健利用和支出
Shaquib Al Hasan1, Tsung-Hua Shen1, Felix Cheuk Wun Ting1
1Graduate Research Assistant, Social and Administrative Pharmacy Graduate Program, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota.
Journal of the American Pharmacists Association : JAPhA
|September 26, 2025
概括
医疗保险D部分患者的综合药物评估 (CMR) 减少了急诊室的访问和住院. 这种干预措施还降低了非处方医疗保健支出,这表明老年人可能节省成本.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 药物经济学 药物经济学
- 老年医学 老年医学
背景情况:
- 医疗保险D部分计划为符合条件的患者提供药物治疗管理 (MTM) 服务,包括综合药物评估 (CMR).
- 尽管MTM自2006年以来一直在使用,但其在大型,可泛化的医疗保险人群中的实际好处仍未得到充分研究.
研究的目的:
- 评估获得CMR对医疗保健利用和相关费用对Medicare受益人的影响.
- 确定CMR服务是否影响医疗保健服务使用频率和整体医疗支出.
主要方法:
- 一项回顾性队列研究比较了CMR接受者和符合条件的非接受者之间的医疗保健利用率和支出变化.
- 来自20%的Medicare受益者 (65岁以上) 随机样本的数据被链接,包括MTM文件和住院,门诊和处方服务的索赔.
- 差异差异模型分析了急诊室 (ED) 访问,住院和医疗/处方支出的一年变化.
主要成果:
- 接受CMR的患者在CMR后的一年内,ED访问 (0.49%) 和住院 (1.72%) 的概率在统计学上显著降低.
- 这意味着每10,000名接受者住院的次数减少了80次,ED访问次数减少了337次.
- 非处方医疗支出每受益人下降了378美元,处方医疗支出增加了470美元,导致年度总支出净增加了91美元.
结论:
- 该研究表明,CMR服务与老年人医疗保健利用率的减少有关,特别是ED访问和住院的减少.
- 在审查后的一年内,CMR可能有助于降低非处方医疗保健支出.
- 研究结果表明,CMR是Medicare受益人药物管理的宝贵组成部分,有可能优化医疗保健资源使用.
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