多领域生活方式干预对医疗服务使用和成本的影响--来自芬兰预防认知障碍和残疾的老年干预研究(FINGER)的二次分析:随机对照试验

IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY
Maria Sääskilahti, Jenni Kulmala, Markku Nurhonen, Jenni Lehtisalo, Markku Peltonen, Francesca Mangialasche, Tiina Laatikainen, Timo Strandberg, Riitta Antikainen, Jaakko Tuomilehto, Hilkka Soininen, Miia Kivipelto, Tiia Ngandu
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引用次数: 0

摘要

背景 芬兰预防认知障碍和残疾的多领域生活方式干预研究(FINGER,N = 1259)是一项随机对照试验,对老年人的发病率产生了有益的影响,但这种生活方式干预会在多大程度上影响医疗服务的使用及其成本,尤其是长期成本,目前尚不清楚。本研究调查了为期两年的 FINGER 多领域干预对 8 年随访期间医疗服务使用的影响。同时还对服务使用成本进行了评估。方法 对 FINGER 参与者的医疗服务使用情况(住院和长期护理天数、急诊就诊次数、门诊就诊次数、家庭护理、初级保健医生和初级保健护士)进行分析。试验对象为 60-77 岁有认知障碍风险的社区居民,他们被随机分配到多领域干预组或对照组。成本以所用服务的平均成本进行评估。结果 干预组和对照组的医疗费用总额没有明显差异。不过,干预组参与者的住院治疗(RR 0.73,95% CI 0.54-1.00)和急诊服务(RR 0.83,95% CI 0.70-0.97)使用率低于对照组。尤其是男性的住院率更低。其他类型医疗服务的使用在两组之间没有差异。干预组的医疗服务使用成本(不包括长期护理)更低(RR 0.81,95% CI 0.68-0.99)。结论 FINGER干预措施有可能减少住院治疗和急诊就诊的需求以及相关费用,尤其是在男性中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The effect of multidomain lifestyle intervention on health care service use and costs - secondary analyses from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER): a randomised controlled trial
Background The Finnish multidomain lifestyle intervention study to prevent cognitive impairment and disability (FINGER, N = 1259), a randomised controlled trial had beneficial effects on morbidity in older people, but to what extent such a lifestyle intervention may affect the use of health care services and their costs especially in long term are unknown. Objective This study investigated the effect of a two-year FINGER multidomain intervention on health care service use during the 8-year follow-up. The costs of service use were also evaluated. Methods Health care service use obtained from national health care registers (days of inpatient hospital stay and long-term care, number of visits to emergency services, hospital as outpatient, home care, primary care physician and primary care nurse) was analysed among participants of the FINGER. Trial targeted community-dwelling people aged 60–77 years at risk for cognitive impairment, who were randomly allocated to the multidomain intervention or control group. Costs were evaluated as the mean costs of services used. Results There were no significant differences in total health care costs between the intervention and control groups. The participants in the intervention group, however, had a lower use of the hospital inpatient care (RR 0.73, 95% CI 0.54–1.00) and emergency services (RR 0.83, 95% CI 0.70–0.97) than those in the control group. Hospital inpatient care was lower especially among men. The use of other types of health care services did not differ between the groups. The costs of health care service use without including long-term care were lower in the intervention group (RR 0.81, 95% CI 0.68–0.99). Conclusions The FINGER intervention has a potential to reduce the need for the inpatient hospital care and emergency visits and associated costs, especially among men.
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来源期刊
Age and ageing
Age and ageing 医学-老年医学
CiteScore
9.20
自引率
6.00%
发文量
796
审稿时长
4-8 weeks
期刊介绍: Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life.
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