高使用者护理计划项目:一个网络倡议,以减少高风险患者中不适当的资源利用
Vanessa Reese1, Justin Psaila2, Marisa Schwartz3
1Research and Innovation, St. Luke's University Health Network, Bethlehem, USA.
Cureus
|February 9, 2026
概括
大量使用者会增加医疗保健费用. 使用多学科团队和个性化护理计划 (ICPs) 的计划显著降低了医疗费用和患者访问急诊室和医院的费用.
科学领域:
- 医疗保健管理的管理
- 卫生经济学 卫生经济学
- 提高质量 提高质量
背景情况:
- 美国医疗保健成本的上升受到高使用者 (HUs) 的显著影响,这是一个小的患者子集.
- 医疗保健部门占医疗保健支出的近50%,通常使用资源不成比例和不必要.
- 解决过度利用的多因素原因需要创新的,多方面的解决方案.
研究的目的:
- 评估一项全面计划在识别高使用者 (HU) 方面的有效性.
- 评估个性化护理计划 (ICP) 对减少医疗资源过度使用和相关成本的影响.
- 测试质量改进过程和ICP减少医疗保健支出和利用率的假设.
主要方法:
- 一个多学科团队根据2021年7月至2025年7月的DHHS定义确定了HUs.
- 为每个患者创建了个性化护理计划 (ICP),并与他们的电子病历 (EMR) 联系起来.
- 住院,门诊和急诊部 (ED) 设施的成本和利用率在ICP实施前后被测量.
主要成果:
- 190名患者参加了ICP;平均年龄为45.15岁,其中62.6%是女性.
- 在ICP实施后的四年研究期间,收费减少了4091万美元.
- 统计学上显著的下降是注意到平均ED访问 (14.18至6.75),住院访问 (4.43至2.41),和住院成像研究 (9.35至5.41).
结论:
- 大量使用者对过度医疗保健开支做出了重大贡献.
- 结合多学科团队,标准化 HU 识别和 ICP 的混合方法有效降低了医疗保健成本.
- 这种综合策略还减少了急诊室 (ED) 和住院患者的访问,以及不必要的成像.
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