Kottke Thomas E, Maciosek Michael V, Huebsch Jacquelyn A, McGinnis Paul, Nichols Jolleen M, Parker Emily D, Tillema Juliana O
HealthPartners Institute, 8170 33rd Ave South, Mail Stop 21110X, Bloomington, MN 55425. E-mail:
Am J Manag Care. 2016 Aug 1;22(8):e283-6. doi: 10.37765/ajmc.2016.86765.
Although team-based care can improve coronary heart disease (CHD) risk factors and is considered cost-effective from a healthcare system perspective, little is known about the financial impact of team-based primary care for secondary prevention of CHD. The purpose of this study was to define the impact of team-based care for CHD on utilization, costs, and revenue of a private primary care practice.
Interrupted time series analysis.
Between March 1, 2010, and March 31, 2013, we assisted a private medical practice, comprising 5 primary care clinic sites, to organize and deliver team-based care for patients with CHD. We used billing records and the registered nurse care manager's diary to calculate the cost of team-based care, differences in the average number of visits per patient, and revenue per patient before and after the implementation of team-based care.
The net cost of team-based primary care was $291 per patient over the 1-year period of observation.
The findings from this study are consistent with other economic analyses of team-based care and suggest that payment for care must be restructured if patients are expected to enjoy the benefits of team-based primary care.
尽管基于团队的护理可以改善冠心病（CHD）危险因素，并且从医疗保健系统的角度来看被认为具有成本效益，但对于基于团队的初级护理对冠心病二级预防的财务影响知之甚少。本研究的目的是确定基于团队的冠心病护理对私人初级护理机构的利用率、成本和收入的影响。
间断时间序列分析。
在2010年3月1日至2013年3月31日期间，我们协助一家由5个初级护理诊所组成的私人医疗机构为冠心病患者组织并提供基于团队的护理。我们使用计费记录和注册护士护理经理的日记来计算基于团队的护理成本、实施基于团队的护理前后每位患者平均就诊次数的差异以及每位患者的收入。
在1年的观察期内，基于团队的初级护理的净成本为每位患者291美元。
本研究的结果与其他基于团队的护理经济分析一致，表明如果期望患者享受基于团队的初级护理的益处，就必须重新调整护理支付方式。
