疾病管理-健康促进护士干预对个人护理服务使用及费用的影响。

Impact of a disease management-health promotion nurse intervention on personal assistance use and expenditures.

作者信息

Meng Hongdao, Friedman Bruce, Dick Andrew W, Liebel Dianne, Wamsley Brenda R, Eggert Gerald M, Mukamel Dana B

机构信息

State University of New York at Stony Brook, Stony Brook, New York, USA.

出版信息

Home Health Care Serv Q. 2009;28(4):113-29. doi: 10.1080/01621420903579669.

DOI:10.1080/01621420903579669

PMID:23098286

Abstract

The purpose of this study is to evaluate the effect of a primary care affiliated disease management-health promotion nurse intervention on paid personal assistance (PA) use and expenditures among Medicare beneficiaries with disabilities. We analyzed data on 570 community-dwelling Medicare beneficiaries aged 65 years and older who participated in the Medicare Primary and Consumer-Directed Care Demonstration, a randomized controlled trial. We estimated a two-part model to test the effect of the nurse intervention on PA use and expenditures during the 2 years after study entry. Adjusting for covariates, average annual PA expenditures were $1,464 (29%) lower per person in the intervention group as compared to the control group. The findings of this study will help policy makers and practitioners understand the potential benefit of primary care affiliated nurse home visiting interventions on PA expenditures.

摘要

本研究的目的是评估初级保健附属疾病管理-健康促进护士干预措施对残疾医疗保险受益人的有偿个人护理（PA）使用情况及费用支出的影响。我们分析了570名年龄在65岁及以上、参与医疗保险初级和消费者导向护理示范项目（一项随机对照试验）的社区居住医疗保险受益人的数据。我们估计了一个两部分模型，以检验护士干预措施对研究入组后两年内PA使用情况及费用支出的影响。在对协变量进行调整后，与对照组相比，干预组人均年PA费用支出降低了1464美元（29%）。本研究结果将有助于政策制定者和从业者了解初级保健附属护士家访干预措施对PA费用支出的潜在益处。