联合设计的仪表板与慢性病和晚期癌症患者使用昂贵的医疗服务之间的关联:倾向性得分调整差异研究
Saki Amagai1, Alexandra Harris1, Nisha Mohindra1
1Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Journal of medical Internet research
|November 21, 2025
概括
一个患者报告结果 (PRO) 仪表板减少了化疗相关的急性护理使用,但增加了晚期癌症患者计划的再入院. 仪表板显示对慢性病患者没有影响,表明需要量身定制的实施.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 数字健康数字健康
- 以患者为中心的护理
背景情况:
- 美国医疗保健面临着不断上升的成本和转向以患者为中心的护理和患者报告结果 (PRO) 的转变.
- 在共享决策中利用PRO可以改善结果并减少慢性疾病的医疗保健利用率.
研究的目的:
- 评估基于PRO的临床仪表板对高级癌症和慢性病 (CKD) 患者昂贵的医疗服务使用的影响.
- 评估仪表板对计划外入院,急诊室访问和再入院的影响.
主要方法:
- 准实验性,倾向分数加权,对例行收集数据 (2020年6月-2022年1月) 的差异分析.
- 在晚期癌症和CKD队列中,将仪表板用户与匹配的非用户进行比较.
- 主要结局:意外入院,急救诊所,急症护理日,七天再入院;次要结局:化疗,预先指示,临终关怀,慢性病特异性急症护理.
主要成果:
- 在晚期癌症患者中,PRO仪表板与更少的化疗相关急性护理接触 (OR 0.35) 相关,但显著更高的7天再入院 (OR 8.58).
- 观察到意外入院的数量没有显著减少,急性护理日数增加.
- 在慢性病队列中,没有发现主要或慢性病特异性结局的显著差异.
结论:
- 瘤学中的PRO仪表板减少了化疗期间的急性护理,但增加了计划的早期再入院,对CKD患者没有影响.
- 这些混合结果强调了需要为特定的临床环境定制PRO仪表板,并将其集成到实时数据利用工作流程中.
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