Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wroclaw, Poland.
Department of Health Care Services, Polish National Health Fund, Central Office in Warsaw, 02-528 Warsaw, Poland.
Int J Environ Res Public Health. 2023 Mar 11;20(6):4980. doi: 10.3390/ijerph20064980.
The benefits of coordinating care between healthcare professionals and institutions are the main drivers behind reforms to the payment and delivery system for healthcare services. The purpose of this study was to analyse the costs incurred by the National Health Fund in Poland related to the comprehensive care model for patients after myocardial infarction (CCMI, in Polish: KOS-Zawał).
The analysis involved data from 1 October 2017 to 31 March 2020 for 263,619 patients who received treatment after a diagnosis of first or recurrent myocardial infarction as well as data for 26,457 patients treated during that period under the CCMI programme.
The average costs of treating patients covered by the full scope of comprehensive care and cardiac rehabilitation under the programme (EUR 3113.74/person) were higher than the costs of treating patients outside of that programme (EUR 2238.08/person). At the same time, a survival analysis revealed a statistically significantly lower probability of death ( < 0.0001) in the group of patients covered by CCMI compared to the group not covered by the programme.
The coordinated care programme introduced for patients after myocardial infarction is more expensive than the care for patients who do not participate in the programme. Patients covered by the programme were more often hospitalised, which might have been due to the good coordination between specialists and responses to sudden changes in patients' conditions.
协调医疗保健专业人员和机构之间的护理的好处是医疗保健服务支付和交付系统改革的主要驱动力。本研究的目的是分析波兰国家卫生基金（National Health Fund）因心肌梗死后全面护理模式（CCMI，波兰语：KOS-Zawał）而产生的相关成本。
分析涵盖了 2017 年 10 月 1 日至 2020 年 3 月 31 日期间首次或复发性心肌梗死后接受治疗的 263619 名患者的数据，以及同期在 CCMI 计划下接受治疗的 26457 名患者的数据。
接受全面护理和心脏康复综合计划治疗的患者（3113.74 欧元/人）的平均治疗费用高于未接受该计划治疗的患者（2238.08 欧元/人）。同时，生存分析显示，在接受 CCMI 计划覆盖的患者群体中，死亡概率明显低于未接受该计划的患者群体（<0.0001）。
为心肌梗死后患者引入的协调护理计划比未参与该计划的患者的护理费用更高。该计划覆盖的患者住院治疗的情况更为常见，这可能是由于专家之间的良好协调以及对患者病情变化的及时响应。
