Ye Zhaojia, Jiang Yawen
Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China.
School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong, China.
Cost Eff Resour Alloc. 2022 Jun 25;20(1):28. doi: 10.1186/s12962-022-00361-4.
Recently, integrated care has received tremendous popularity in China, a leading example of which is the Luohu model. In the present analysis, we aimed to examine the impacts of the Luohu model on the quality and costs of inpatient care.
We conducted a retrospective analysis using administrative claims databases of Shenzhen City (the city that the Luohu district sits) from Jan 2015-Apr 2017, which encompassed the time before and after the implementation of the pilot model. The outcomes were 30-day readmission, inpatient costs, and length of stay (LOS). Multivariable difference-in-difference analyses were conducted.
In the first year following the integration, the Luohu model did not have impacts on any of the outcomes. Although its effect on readmission (ratio of odds ratio: 1.082; 95% CI: 0.865 to 1.353) was still not identified in the first four months of the second post-integration year, it decreased inpatient costs by CN¥ 1224.1 (95% CI: 372.7 to 2075.5) and LOS by 0.938 days (95% CI: 0.0416 to 1.835) per hospitalization episode during the same period.
The Luohu model may reduce costs and LOS in the long term. It is potentially a viable approach to improve the value of inpatient care in China.
近年来，整合照护在中国广受欢迎，其中一个典型例子就是罗湖模式。在本分析中，我们旨在探讨罗湖模式对住院照护质量和成本的影响。
我们利用深圳市（罗湖区所在城市）2015年1月至2017年4月的行政索赔数据库进行了一项回顾性分析，该时间段涵盖了试点模式实施前后。结局指标包括30天再入院率、住院费用和住院时长（LOS）。进行了多变量差分分析。
整合后的第一年，罗湖模式对任何结局指标均无影响。尽管在整合后第二年的前四个月仍未发现其对再入院率的影响（优势比比值：1.082；95%CI：0.865至1.353），但同期每例住院患者的住院费用降低了1224.1元人民币（95%CI：372.7至2075.5），住院时长缩短了0.938天（95%CI：0.0416至1.835）。
从长期来看，罗湖模式可能会降低成本和缩短住院时长。它可能是提高中国住院照护价值的一种可行方法。
