在30天内支出的变化和支出的驱动因素 基于急诊室的护理情节
Keith E Kocher1,2,3,4, Alexander T Janke5,6, Kristen P Hassett7
1Department of Emergency Medicine, School of Medicine, University of Michigan, Ann Arbor, MI, USA. kkocher@umich.edu.
患有充血性心力衰竭 (CHF),慢性阻塞性肺病 (COPD) 和肺炎的急诊室 (ED) 访问显示,各医院的支出差异很大. 这种变化主要是由于与最初的急救诊所和随后的住院费用相关的成本.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健经济学 医疗保健经济学
- 临床操作 临床操作
背景情况:
- 紧急部门 (ED) 访问是急性护理的关键入口点,影响患者的治疗结果和医疗保健成本.
- 目前的医疗保健模式很少根据最初的ED遭遇来定义护理情节.
- 了解基于ED的插曲支出对于提高医疗保健质量和效率至关重要.
研究的目的:
- 分析医院一级的支出变化,用于在ED开始的30天护理.
- 确定这种充血性心力衰竭 (CHF),慢性阻塞性肺病 (COPD) 和肺炎支出变化的关键驱动因素.
- 为潜在的节约成本和质量改进领域提供见解.
主要方法:
- 一项基于索赔的横截面研究涉及密歇根州83家医院.
- 数据包括在2017年至2022年期间被诊断患有心肺炎,COPD或肺炎的成年患者.
- 分析了根据风险调整的,价格标准化的30天的总和组件ED支付.
主要成果:
- 对于心脏病 (24.7%),COPD (33.1%) 和肺炎 (31.9%) 观察到显著的医院级支付变化.
- 更高的支出与指数ED访问和住院期间的成本增加有很强的相关性.
- 后急性护理和专业费用也导致了支付差异,在各种疾病中产生不同的影响.
结论:
- 在30天的ED支付基于CHF,COPD和肺炎在医院之间存在实质性的差异.
- 这种变化的主要驱动因素是初次急救访问和相关住院期间产生的成本.
- 需要进一步的研究来确定这些支出差异是否反映了护理质量或运营效率的差异.
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