Blackwell Steven A, Shrank William H, Riley Gerald F
J Med Pract Manage. 2016 Jan-Feb;31(4):200-8.
The purpose of our study was to compare performance between Medicare Advantage and stand-alone prescription drug plans on the two quality assurance measures of drug-disease interaction and drug-drug interaction for elderly heart failure beneficiaries. Performance on the drug-disease interaction measure appeared more problematic for stand-alone plan enrollees compared with Medicare Advantage plan enrollees. No statistical difference existed between the plans regarding drug-drug interactions. It appears there may be considerable room for more sophisticated use of disease profiling in the processing of drug claims. The provision of richer clinical data is an essential step to improving performance on the drug-disease interaction measure.
我们研究的目的是比较医疗保险优势计划和独立处方药计划在老年心力衰竭受益人的药物-疾病相互作用和药物-药物相互作用这两项质量保证措施方面的表现。与医疗保险优势计划参保者相比，独立计划参保者在药物-疾病相互作用指标上的表现似乎问题更大。在药物-药物相互作用方面，两个计划之间不存在统计学差异。在处理药品理赔时，对疾病特征进行更精细的应用似乎还有很大空间。提供更丰富的临床数据是提高药物-疾病相互作用指标表现的关键一步。
