远程医疗急诊室转换护理计划:以价值为基础的创新
Allyson Kreshak1,2, Itzik Fadlon3, Karna Malaviya3
1University of California, San Diego Health, Population Health Services Organization, San Diego, California.
The western journal of emergency medicine
|November 5, 2025
概括
一个远程医疗转换护理计划减少了医疗保险急救部门在出院后8-14天之间重新访问. 该计划显著节省了成本,突出了其在改善患者护理过渡过程中的价值.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 远程医疗服务是远程医疗服务.
- 以价值为基础的护理
背景情况:
- 紧急诊所 (ED) 面临着重招患者的挑战,特别是那些以价值为基础的合同.
- 开发了一项远程医疗转换护理 (TOC) 计划,以管理出院后的患者需求.
- 这项研究旨在评估这个ED-TOC程序对ED重复访问的影响.
研究的目的:
- 确定远程医疗ED-TOC计划与ED复诊率之间的关联.
- 评估该计划对退院后初级保健医生 (PCP) 访问和住院的影响.
- 估计ED-TOC程序所产生的成本节约.
主要方法:
- 对两次ED (2021年8月至2023年7月) 退院的医疗保险受益人的回顾性队列研究.
- 使用差异差异 (DID) 策略,比较医疗保险 (治疗) 和医疗补助 (控制) 受益人.
- 主要结果:14天和30天的ED复诊率;次要结果:PCP访问,住院和成本节省.
主要成果:
- 与对照组相比,Medicare受益人计划启动后的14天ED复诊减少了1.77% (p=0.03).
- 计划启动后的医疗保险受益人14天PCP访问增加了10.3% (p=0.03).
- 在30天的ED复诊或住院没有显著差异;30天的PCP访问显著增加 (p=0.005).
结论:
- 该ED-TOC计划与医疗保险ED重访减少在8-14日后释放期间.
- 该计划没有显著影响1-7天或30天的ED复查.
- 在24周的时间里,保守的成本节约估计为215,779美元.
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