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预测骨科疾病患者在全科医生指导下护理的直接医疗成本。

Predicting direct healthcare costs of general practitioner-guided care in patients with musculoskeletal complaints.

机构信息

Department Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Amsterdam Movement Sciences Research Institute, Amsterdam, the Netherlands.

Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Research Institute Amsterdam, the Netherlands.

出版信息

Pain. 2024 Feb 1;165(2):404-411. doi: 10.1097/j.pain.0000000000003028. Epub 2023 Aug 15.

Abstract

Information on healthcare utilization and costs of general practitioner (GP)-guided care in patients with musculoskeletal complaints is important for keeping healthcare affordable and accessible. A registry-based study was performed to describe healthcare utilization and costs of GP-guided care in patients with musculoskeletal complaints and to predict having higher direct healthcare costs. Healthcare costs of GP-guided care included all healthcare resources used by patients due to a musculoskeletal condition in 2018. Data were extracted from the database with a 1-year follow-up and descriptively analyzed. A general linear model was developed to predict having higher direct healthcare costs. In total, 403,719 patients were included, of whom 92% only received a single consultation. The number of referrals varied across the different types of complaints. Total annual direct healthcare costs amounted to €39,180,531, of which a key cost driver was referrals. Primary care consultations accounted for the largest part of referral-related costs. For all musculoskeletal conditions combined, the mean annual direct healthcare cost per patient was €97 (SEM = €0.18). Older age, being a woman, low socioeconomic status, spine complaints, high number of musculoskeletal diagnoses, and a high comorbidity score were predictive of having higher direct healthcare costs and explained 0.7% of the variance. This study showed that mean annual direct healthcare costs of GP-guided care in patients with musculoskeletal conditions were relatively low and did not differ considerably across conditions. The predictive model explained a negligible part of the variance in costs. Thus, it is unclear which factors do predict high direct healthcare costs in this population.

摘要

关于肌肉骨骼疾病患者接受全科医生(GP)指导护理的医疗保健利用和成本的信息对于保持医疗保健的可负担性和可及性非常重要。进行了一项基于登记的研究,以描述肌肉骨骼疾病患者接受 GP 指导护理的医疗保健利用和成本,并预测更高的直接医疗保健成本。GP 指导护理的医疗保健成本包括 2018 年患者因肌肉骨骼疾病而使用的所有医疗保健资源。从具有 1 年随访的数据库中提取数据并进行描述性分析。开发了一个一般线性模型来预测更高的直接医疗保健成本。总共纳入了 403719 名患者,其中 92%仅接受了一次咨询。不同类型的投诉转诊数量不同。总年度直接医疗保健费用为 39180531 欧元,其中转诊是主要成本驱动因素。初级保健咨询占转诊相关费用的最大部分。对于所有肌肉骨骼疾病,每位患者的平均年直接医疗保健费用为 97 欧元(SEM=0.18)。年龄较大、女性、社会经济地位较低、脊柱疾病、肌肉骨骼诊断数量较多以及较高的合并症评分是预测更高直接医疗保健成本的因素,占成本方差的 0.7%。这项研究表明,肌肉骨骼疾病患者接受 GP 指导护理的平均年度直接医疗保健成本相对较低,并且在不同疾病之间差异不大。预测模型仅解释了成本方差的一小部分。因此,尚不清楚哪些因素可预测该人群中的高直接医疗保健成本。

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