基于ACO级行政索赔的措施,为患有复杂慢性疾病的患者提供在家停留的时间
Kyle Bagshaw1, Yongfei Wang1,2, Zhenqiu Lin1,2
1Yale New Haven Health Services Corporation/Center for Outcomes Research and Evaluation (YNHHSC/CORE), New Haven, CT.
负责护理组织 (ACO) 的新"在家日"措施可靠地跟踪患者在设施之外的时间. 这个工具支持协调,社区为复杂的慢性疾病的护理.
科学领域:
- 医疗保健质量测量 医疗保健质量测量
- 医疗保健服务研究 医疗服务研究
- 以价值为基础的护理
背景情况:
- 对跟踪患者在家和社区所花费时间的指标的需求日益增长.
- 需要激励协调的初级保健服务,减少急性护理的使用.
- 专注于改善患者的治疗结果和降低医疗保健成本.
研究的目的:
- 开发和验证一个基于索赔的"家居日"措施,用于负责护理组织 (ACO).
- 评估Medicare复杂慢性疾病受益人每年在急性或后急性住院设施之外度过的天数.
- 支持转向以家庭为中心和以社区为中心的护理模式.
主要方法:
- 在610个共享储蓄计划ACO中,利用了2017-2018年Medicare服务费患者的索赔数据.
- 员工分半可靠性测试和专家调查以评估有效性.
- 调整了51个临床/人口学变量,医疗补助双重资格,死亡率和养老院入院.
主要成果:
- "在家的日子"测量表现出高可靠性 (0.833) 和专家之间的面部有效性.
- 在ACO中调整后在家的平均日数为330.4 (范围:291.0-345.9).
- 该指标显示与相关的医疗保健利用指标的总体相关性.
结论:
- "在家的日子"ACO措施是评估护理协调的可靠和有效工具.
- 该措施可以激励提供协调,以预防为重点的家庭和社区护理.
- 通过量化传统医疗机构之外的时间来支持基于价值的护理倡议.
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