一项多中心医疗质量倡议对降低炎症性肠病患者非计划性医疗利用的健康经济影响
Health Economic Impact of a Multicenter Quality-of-Care Initiative for Reducing Unplanned Healthcare Utilization Among Patients With Inflammatory Bowel Disease.
作者信息
Almario Christopher V, Kogan Lawrence, van Deen Welmoed K, Scott Frank I, Singh Siddharth, Hou Jason K, Lum Donald, Aguilar Humberto, Betteridge John, Flynn Ann, Gerich Mark, Kaufman Lia, Mattar Mark C, Mize Carrie, Ostrov Arthur, Shah Samir A, Younes Ziad, Weaver S Alandra, Heller Caren, Siegel Corey A, Melmed Gil Y
机构信息
Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California, USA.
出版信息
Am J Gastroenterol. 2021 Dec 1;116(12):2459-2464. doi: 10.14309/ajg.0000000000001540.
INTRODUCTION
A multicenter adult inflammatory bowel disease learning health system (IBD Qorus) implemented clinical care process changes for reducing unplanned emergency department visits and hospitalizations using a Breakthrough Series Collaborative approach.
METHODS
Using Markov decision models, we determined the health economic impact of participating in the Collaborative from the third-party payer perspective.
RESULTS
Across all 23 sites, participation in the Collaborative was associated with lower annual costs by an average of $2,528 ± $233 per patient when compared with the baseline period.
DISCUSSION
Implementing clinical care process changes using a Collaborative approach was associated with overall cost savings. Future work should examine which specific interventions are most effective and whether such cost savings are sustainable.
引言
一个多中心成人炎症性肠病学习健康系统（IBD Qorus）采用突破系列协作方法实施了临床护理流程变革，以减少计划外急诊科就诊和住院情况。
方法
我们使用马尔可夫决策模型，从第三方支付方的角度确定参与该协作的健康经济影响。
结果
与基线期相比，在所有23个地点，参与该协作与每位患者平均每年成本降低2528美元±233美元相关。
讨论
采用协作方法实施临床护理流程变革与总体成本节约相关。未来的工作应研究哪些具体干预措施最有效，以及这种成本节约是否可持续。
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