在医疗保险收费服务受益者中预先预期的护理规划访问和COVID-19治疗强度:一项回顾性观察研究
Amber E Barnato1,2, Deanna L Chyn3, Vrushabh P Ladage3
1The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA. Amber.Barnato@dartmouth.edu.
Journal of general internal medicine
|December 12, 2025
概括
在封锁期间,COVID-19的预先护理计划 (aACP) 减少了,但对于高风险患者来说仍然较高. 这种计划与不那么密集的COVID-19治疗有关,包括减少机械通风.
科学领域:
- 老年学是一门学科.
- 公共卫生 公共卫生
- 卫生政策 卫生政策
背景情况:
- 2020年3月,针对高风险的老年人发布了预期性COVID-19预先护理计划 (aACP) 的指南.
- 这项研究检查了对这些指南的反应及其与COVID-19治疗强度的关联.
研究的目的:
- 评估在COVID-19大流行期间医疗保险受益人中的aACP的采用情况.
- 分析aACP和COVID-19治疗强度,特别是机械通风之间的关系.
主要方法:
- 一个使用2020年医疗保险索赔数据的追溯回归不连续性设计 (RDD).
- 分析包括后勤回归,以确定aACP的预测因素及其与机械通风的关联.
主要成果:
- 预期的ACP访问在封锁后下降了54%,但高风险群体 (例如多病症,晚期癌症,痴呆症,ESRD) 的下降程度较低.
- 在COVID-19患者中,aACP与住院治疗的增加有关,但侵袭性机械通风的使用减少.
结论:
- 医疗保健提供者遵守高风险患者中预期COVID-19 ACP的建议.
- 预期的COVID-19 ACP与治疗强度降低有关,突出显示了在未来的流行病中有效识别风险因素的必要性.
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