家庭心脏病医院可减少高费用心血管疾病患者的住院次数和费用。

IF 2.4 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Michael Shen, Kareem Osman, Daniel M. Blumenthal, Kaelin DeMuth, Yixiang Liu
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引用次数: 0

摘要

背景:在管理高需求、高费用(HNHC)患者方面,还没有一种广为接受的护理模式。我们假设,提供纵向、医院级居家护理的家庭心脏病医院(H3)将提高心血管疾病(CVD)HNHC 患者的护理质量并降低成本:评估H3(提供纵向医院级居家护理)的注册、护理质量和HNHC心血管疾病患者的费用之间的关系:这项回顾性受试者内队列研究使用保险理赔和电子健康记录数据,对 H3 之前、期间和之后的未调整和调整后年化住院率、护理总成本、A 部分成本和死亡率进行评估:在 2019 年 2 月至 2021 年 10 月期间,有 94 名患者参加了 H3。患者平均年龄为 75 岁,50% 为女性。常见合并症包括充血性心力衰竭(50%)、心房颤动(37%)和冠心病(44%)。与加入前相比,加入 H3 可显著降低年化住院率(绝对降低率 (AR):2.4 次住院/年,95% 置信区间 [95%CI]:-0.8,-4.0;P 结论:纵向家庭护理模式具有良好的前景:纵向家庭护理模式有望提高心血管疾病高危人群的医疗质量并降低医疗支出。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Home Heart Hospital Associated With Reduced Hospitalizations and Costs Among High-Cost Patients With Cardiovascular Disease

Home Heart Hospital Associated With Reduced Hospitalizations and Costs Among High-Cost Patients With Cardiovascular Disease

Background

There is no widely accepted care model for managing high-need, high-cost (HNHC) patients. We hypothesized that a Home Heart Hospital (H3), which provides longitudinal, hospital-level at-home care, would improve care quality and reduce costs for HNHC patients with cardiovascular disease (CVD).

Objective

To evaluate associations between enrollment in H3, which provides longitudinal, hospital-level at-home care, care quality, and costs for HNHC patients with CVD.

Methods

This retrospective within-subject cohort study used insurance claims and electronic health records data to evaluate unadjusted and adjusted annualized hospitalization rates, total costs of care, part A costs, and mortality rates before, during, and following H3.

Results

Ninety-four patients were enrolled in H3 between February 2019 and October 2021. Patients' mean age was 75 years and 50% were female. Common comorbidities included congestive heart failure (50%), atrial fibrillation (37%), coronary artery disease (44%). Relative to pre-enrollment, enrollment in H3 was associated with significant reductions in annualized hospitalization rates (absolute reduction (AR): 2.4 hospitalizations/year, 95% confidence interval [95% CI]: −0.8, −4.0; p < 0.001; total costs of care (AR: −$56 990, 95% CI: −$105 170, −$8810; p < 0.05; and part A costs (AR: −$78 210, 95% CI: −$114 770, −$41 640; p < 0.001). Annualized post-H3 total costs and part A costs were significantly lower than pre-enrollment costs (total costs of care: −$113 510, 95% CI: −$151 340, −$65 320; p < 0.001; part A costs: −$84 480, 95% CI: −$121 040, −$47 920; p < 0.001).

Conclusions

Longitudinal home-based care models hold promise for improving quality and reducing healthcare spending for HNHC patients with CVD.

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来源期刊
Clinical Cardiology
Clinical Cardiology 医学-心血管系统
CiteScore
5.10
自引率
3.70%
发文量
189
审稿时长
4-8 weeks
期刊介绍: Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.
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