Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
J Am Geriatr Soc. 2012 Jun;60(6):1051-6. doi: 10.1111/j.1532-5415.2012.03992.x.
To investigate the business case of postdischarge care transition (PDCT) among Medicare beneficiaries by conducting a cost-benefit analysis.
Randomized controlled trial.
A general hospital in upstate New York State.
Elderly Medicare beneficiaries being treated from October 2008 through December 2009 were randomly selected to receive services as part of a comprehensive PDCT program (intervention--173 patients) or regular discharge process (control--160 patients) and followed for 12 months.
The intervention comprised five activities: development of a patient-centered health record, a structured discharge preparation checklist of critical activities, delivery of patient self-activation and management sessions, follow-up appointments, and coordination of data flow.
Cost-benefit ratio of the PDCT program; self-management skills and abilities.
The 1-year readmission analysis revealed that control participants were more likely to be readmitted than intervention participants (58.2% vs 48.2%; P = .08); with most of that difference observed in the 91 to 365 days after discharge. Findings from the cost-benefit analysis revealed a cost-benefit ratio of 1.09, which indicates that, for every $1 spent on the program, a saving of $1.09 was realized. In addition, participating in a care transition program significantly enhanced self-management skills and abilities.
Postdischarge care transition programs have a dual benefit of enhancing elderly adults' self-management skills and abilities and producing cost savings. This study builds a case for the inclusion of PDCT programs as a reimbursable service in benefit packages.
通过成本效益分析，研究医疗保险受益人的出院后护理交接（PDCT）业务案例。
随机对照试验。
纽约州北部的一家综合医院。
2008 年 10 月至 2009 年 12 月接受治疗的老年医疗保险受益人被随机选择接受服务，作为全面 PDCT 计划（干预组-173 名患者）或常规出院流程（对照组-160 名患者）的一部分，并随访 12 个月。
干预措施包括五项活动：制定以患者为中心的健康记录、制定关键活动的结构化出院准备清单、提供患者自我激活和管理课程、随访预约以及协调数据流。
PDCT 计划的成本效益比；自我管理技能和能力。
1 年再入院分析显示，对照组患者再入院的可能性高于干预组（58.2%比 48.2%；P=0.08）；大部分差异发生在出院后 91 至 365 天。成本效益分析的结果显示成本效益比为 1.09，这表明，每花费 1 美元用于该计划，就可节省 1.09 美元。此外，参与护理交接计划显著增强了老年人的自我管理技能和能力。
出院后护理交接计划具有双重益处，既增强了老年人的自我管理技能和能力，又节省了成本。本研究为将 PDCT 计划纳入福利套餐中的可报销服务提供了依据。
