雇主赞助的健康诊所的综合物理医学可提高医疗质量并降低成本。
Integrated Physical Medicine at Employer-Sponsored Health Clinics Improves Quality of Care at Reduced Cost.
机构信息
Crossover Health, San Clemente, CA (Mr Lord, Mr Wright, Ms Fung, Mr Lederhaus, Dr Taylor, Mr Watts, Dr Hagg, and Dr Bravata); Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA (Dr Bravata); Untold Content, Cincinnati, OH (Dr Taylor and Mr Watts).
出版信息
J Occup Environ Med. 2019 May;61(5):382-390. doi: 10.1097/JOM.0000000000001536.
OBJECTIVE
The aim of the study was to evaluate clinical and economic outcomes associated with integrating physical medicine in employer-sponsored clinics.
METHODS
Retrospective cohort analysis comparing clinical and economic outcomes of physical medicine services delivered in employer-sponsored clinics with the community.
RESULTS
Integrating physical medicine in employer-sponsored clinics decreased wait times to access these services to 7 days (2 to 4× faster than in the community). Patients receiving care in employer-sponsored clinics experienced marked improvements in fear of pain avoidance behaviors (P < 0.00001) and functional status (P < 0.01) in eight fewer visits than in the community (P < 0.0001), resulting in $472 to $630 savings/patient episode. Noncancer patients received 1/10th the opioid prescriptions in employer-sponsored clinics compared with the community (2.8% vs 20%). Patients were highly likely to recommend integrated employer-sponsored care (Net Promoter Score = 84.7).
CONCLUSIONS
Findings suggest robust clinical and economic benefits of integrating physical medicine services into employer-sponsored clinics.
目的
本研究旨在评估将物理医学整合到雇主赞助的诊所中所带来的临床和经济结果。
方法
回顾性队列分析比较了在雇主赞助的诊所和社区中提供物理医学服务的临床和经济结果。
结果
将物理医学整合到雇主赞助的诊所中，将获得这些服务的等待时间缩短至 7 天（比社区快 2 到 4 倍）。在雇主赞助的诊所接受治疗的患者在恐惧回避行为（P<0.00001）和功能状态（P<0.01）方面有明显改善，就诊次数比社区少 8 次（P<0.0001），每位患者节省 472 至 630 美元。与社区相比，雇主赞助的诊所中非癌症患者开出的阿片类药物处方减少了十分之一（2.8%比 20%）。患者非常愿意推荐整合的雇主赞助护理（净推荐值为 84.7）。
结论
研究结果表明，将物理医学服务整合到雇主赞助的诊所中具有强大的临床和经济效益。
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