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患者复杂健康需求的自我报告的护理协调的质量、健康和成本相关结果。

Self-Reported Quality, Health, and Cost-Related Outcomes of Care Coordination Among Patients with Complex Health Needs.

机构信息

Management, Policy, and Community Health, The University of Texas School of Public Health, Houston, Texas.

Department of Health Management and Policy, School of Public Health, Texas A&M Health Science Center, Texas A&M University, College Station, Texas.

出版信息

Popul Health Manag. 2020 Feb;23(1):59-67. doi: 10.1089/pop.2019.0007. Epub 2019 May 20.

Abstract

Care coordination is an increasingly popular strategy to help patients with complex health conditions manage their diseases more effectively. The purpose of the current study was to assess associations between patient-reported receipt of care coordination and their experiences of health, health care quality, and cost-related outcomes. Regression analyses of data from 431 patients across 13 Texas providers indicate that patients who reported receiving care coordination had higher odds of perceiving having enough information about how to manage their conditions (OR 2.02,  < .01), having information about education and treatments available (OR 1.87,  < .01), and reporting better access to care (beta = .27,  < .01). Receipt of care coordination was not associated with patients' reports of how up-to-date their doctors were about care from other providers, patients' health-related functioning, or patients' intention to return to the emergency department. Patients' reasons for intending to return to the emergency department included the speed of care there relative to alternatives and satisfaction with the quality of care they had received previously in the emergency department. Results suggest that care coordination in usual practice may improve patient preventive care, but not some other health or cost-related outcomes.

摘要

患者护理协调是一种越来越受欢迎的策略,旨在帮助患有复杂健康状况的患者更有效地管理其疾病。本研究的目的是评估患者报告的护理协调与其健康、医疗质量和成本相关结果的体验之间的关联。对来自 13 家德克萨斯州供应商的 431 名患者的数据进行回归分析表明,报告接受护理协调的患者更有可能认为自己拥有足够的信息来管理其病情(优势比 2.02,<.01),了解有关可用教育和治疗的信息(优势比 1.87,<.01),并报告更好的医疗服务可及性(β=0.27,<.01)。接受护理协调与患者对医生了解其他提供者提供的护理的及时性、患者的健康相关功能或患者返回急诊部的意愿没有关联。患者返回急诊部的原因包括相对于其他选择的护理速度和对之前在急诊部接受的护理质量的满意度。结果表明,常规实践中的护理协调可能会改善患者的预防保健,但不会改善其他健康或成本相关结果。

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