Department of Public Health, Medical University of Warsaw, Warsaw, Poland; Medical Department, Medicover Sp. z o.o., Warsaw, Poland.
Collegium of Business Administration, Warsaw School of Economics, Warsaw, Poland.
Value Health Reg Issues. 2021 Sep;25:23-28. doi: 10.1016/j.vhri.2020.07.577. Epub 2021 Feb 5.
The study aimed to examine the number of unnecessary medical procedures and healthcare costs with the use of the educational intervention in Poland.
Secondary data were collected between 2014 and 2015. Analysis of events and cost per patient revealed significant variability and overutilization of diagnostics and other services by physicians practicing in a network of private outpatient clinics in Poland. To reduce unjustified referrals and costs, a 2-year educational intervention was carried out, which included printed evidence-based practice recommendations and quarterly verification of the results from each of the 617 participating physicians. We analyzed the effects of the intervention on the number of medical events and costs with 17 diagnoses generating the highest costs.
After 2 years of the intervention, the number of medical events per patient decreased by over 20% compared to baseline, primarily in orthopedics (by 31%-37%). Moreover, the healthcare costs per patient decreased by about 18% at the end of the intervention. Patient satisfaction remained high during the intervention.
Intervention based on evidence-based practice reduced both the number of unnecessary medical procedures and healthcare costs in the outpatient setting, while not affecting patient satisfaction.
本研究旨在探讨在波兰开展教育干预对减少不必要医疗程序数量和降低医疗成本的效果。
本研究使用了 2014 年至 2015 年期间收集的二级数据。对事件和每位患者的成本进行分析后发现，波兰私立门诊网络中的医生在进行诊断和提供其他服务时存在显著的变异性和过度使用现象。为了减少不合理的转诊和成本，我们开展了为期 2 年的教育干预，其中包括提供基于证据的实践推荐和对 617 名参与医生的每季度结果进行验证。我们对 17 种导致最高成本的诊断进行了分析，以评估该干预对医疗事件数量和成本的影响。
干预 2 年后，每位患者的医疗事件数量比基线减少了 20%以上，主要是在骨科（减少了 31%-37%）。此外，在干预结束时，每位患者的医疗成本降低了约 18%。在干预期间，患者满意度一直保持较高水平。
基于循证实践的干预措施减少了门诊环境中不必要的医疗程序数量和医疗成本，同时并未影响患者满意度。
