Hatcher M E, Green L W, Levine D M, Flagle C E
Soc Sci Med. 1986;22(8):813-9. doi: 10.1016/0277-9536(86)90235-2.
The ability to assign patients to the most appropriate program of intervention would improve patient outcomes and reduce health care costs. This paper evaluates specific potentials of triaging patients into various combinations of health education treatments. Blood pressure improvement among hypertensive patients was measured and the associated treatment cost and savings were compared. Triaging rules were formed empirically from the relationship between patient characteristics selected before the study was conducted and their achieved blood pressure control within each combination of interventions. Patients randomly assigned to seven combinations of three interventions were studied in contrast to patients in a randomized control group. A combination of all three interventions was the most effective program for the undifferentiated (random) patient population, achieving a 49% increase over 18 months in patients with blood pressure under control. By triaging, 51-91% increases in patients with controlled blood pressure were achieved. Educational history of the patients which is a fairly reliable measure was the most efficient triaging variable, showing a 91% increase in patients with blood pressure under control and a relative cost saving of about 400%.
将患者分配到最合适的干预方案的能力将改善患者预后并降低医疗成本。本文评估了将患者分诊到各种健康教育治疗组合中的具体潜力。测量了高血压患者的血压改善情况，并比较了相关的治疗成本和节省情况。根据研究开展前选定的患者特征与每种干预组合中实现的血压控制之间的关系，凭经验形成了分诊规则。与随机对照组的患者相比，对随机分配到三种干预措施的七种组合中的患者进行了研究。对于未分化（随机）患者群体，所有三种干预措施的组合是最有效的方案，在18个月内血压得到控制的患者增加了49%。通过分诊，血压得到控制的患者增加了51%至91%。患者的教育史是一个相当可靠的衡量标准，是最有效的分诊变量，血压得到控制的患者增加了91%，相对成本节省约400%。
