我们是否应该包括痴呆症诊断或认知障碍来预测家庭护理成本? 一个使用真实世界数据的观察性研究
Flurina Meier-Schwarzer1,2,3, Nicole Probst-Hensch4,5, Marc Höglinger6
1Winterthur Institute of Health Economics, School of Management and Law, Zurich University of Applied Sciences, Winterthur, Switzerland. flurina.meier@zhaw.ch.
BMC health services research
|December 22, 2025
概括
痴呆症诊断并没有显著改善家庭护理费用预测. 像日常生活障碍等标准预测因素能够充分预测成本,这表明不需要对痴呆症进行特定调整.
科学领域:
- 老年学是一门学科.
- 卫生经济学 卫生经济学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 痴呆症诊断正在考虑用于医疗保险优势风险调整模型.
- 瑞士正在探索长期护理中痴呆症患者的具体费率.
- 痴呆症诊断对家庭护理费用的预测价值仍在争论中.
研究的目的:
- 为了确定是否包括痴呆症诊断改善了家庭护理成本预测.
- 评估认知障碍措施对成本预测的影响.
- 为了比较具有和没有痴呆症/认知障碍数据的预测模型.
主要方法:
- 对来自瑞士家庭护理机构的观察性多中心研究数据的分析.
- 使用了interRAI-Home Care评估和成本的行政数据.
- 使用通用线性模型 (gamma log-link) 来预测成本.
主要成果:
- 在1035名患者中,有17%的患者被诊断为痴呆症,平均成本较高 (CHF1082比CHF720).
- 日常生活活动 (ADL) 和日常生活工具活动 (IADL) 是关键预测因素.
- 添加痴呆症诊断或认知障碍并没有显著改善预测性能.
结论:
- 调查结果不支持对痴呆症患者的差异化报销或风险调整.
- 像ADL和IADL损伤这样的一般预测因素能够充分预测家庭护理费用.
- 为了验证,需要对各种国际样本进行进一步的研究.
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