初级保健医生连续性是一个一致的措施,与更低的成本和住院住院有关
YoonKyung Chung1, Stephen Petterson1, Mingliang Dai1
1From the Harvey L. Neiman Health Policy Institute, Reston, VA (YKC); The Robert Graham Center, Policy Studies in Family Medicine and Primary Care, Washington, DC (SP); American Board of Family Medicine, Lexington, KY (MD, RLP, AB); The Center for Professionalism & Value in Health Care, Washington, DC (AB).
Journal of the American Board of Family Medicine : JABFM
|January 6, 2026
概括
保持医生连续性可以降低医疗保健成本和住院费用. 一年的评估期足以评估医生在基于价值的护理计划中的连续性.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 初级医疗保健医学 一级医疗保健医学
背景情况:
- 初级保健的连续性与降低成本和在一年内住院的情况有关.
- 初级保健连续性对医疗保健支出和利用的长期影响尚不清楚.
- 这种知识差距对于基于价值的支付模式的成功至关重要.
研究的目的:
- 调查医生级连续性与医疗保健支出和利用之间的关联.
- 在不同的测量期内,从一年到五年,检查这些关联.
- 通过评估测量医生连续性的最佳时间框架来告知基于价值的支付计划.
主要方法:
- 使用2011-2017年医疗保险服务费 (FFS) 索赔数据进行的回顾性队列研究.
- 医生连续性用1至5年的回顾期来衡量.
- 用通用线性模型和逻辑模型来评估支出,住院和急诊室访问,并根据患者和医生因素进行调整.
主要成果:
- 医生连续性更高与总支出显著降低 (7.4%-10.4%) 和住院 (5.5%-8.6%) 和急救诊所 (4.9%-6.3%) 的几率降低有关.
- 观察到最强的关联是在1年的回顾期.
- 这些效应在较长的回顾期出现时略有减弱,表明持续的影响.
结论:
- 医生连续性在各种测量持续时间中显示出与医疗保健成本,住院和急诊室访问减少的一致关联.
- 这些发现的稳定性表明,1年的评估期足以评估医生连续性.
- 一年的测量时间框架可以有效地支持基于价值的支付计划中的医生连续性评估.
关键词:
护理的连续性 护理的连续性医疗保健支出 医疗保健支出住院治疗 住院治疗线性模型 线性模型美国医疗保险 (Medicare) 的医疗保险.以患者为中心的护理医生 医生 医生初级医疗保健是一项主要的医疗保健.过程措施 过程措施提高质量 提高质量回顾性研究回顾性研究更多相关视频
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