准确预测心血管和经济影响的措施,迅速采取行动,并与患者计划合作,以改善高血压控制。

IF 4.5 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Steven P Dehmer, Brent M Egan, Blaine Hardy, Michael V Maciosek, Susan E Sutherland, Stavros Tsipas, Gregory Wozniak
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引用次数: 0

摘要

本研究使用微观模拟来估计广泛采用美国医学协会的“准确测量,快速行动,与高血压患者合作”(AMA MAPTM HTN)质量改进计划可能实现的10年健康和经济结果。方法:采用微观模拟模型,对在全国范围内和不同规模的医疗服务系统中采用MAP HTN项目进行“假设”分析。分析时间为2020-2024年,采用1948 - 2019年各种数据源构建微观模拟模型。超过10年的模型结果包括收缩压(SBP)≥140 mmHg的患病率;心血管疾病(CVD)事件的发生率和CVD相关死亡率;支付人按2021年美元计算避免的医疗费用;还有净成本。结果:对于10年以上的高血压患者,在全国范围内采用MAP HTN计划预计可使平均血压控制提高4.3%,预防61万例CVD事件和12万例CVD死亡。据估计,179亿美元的疾病避免成本中,大部分是在医疗保险患者身上观察到的。与实施MAP HTN计划相关的总费用总计126亿美元,预计在10年内将为卫生保健部门净节省53亿美元。小型和大型医疗服务机构都可以从实施MAP HTN项目中获得经济效益,从支付者那里获得不同水平(5-50%)的共同成本节约。结论:针对BP管理的质量改进方案是有希望的,但需要更多的研究来证实本分析的假设和发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predicted Cardiovascular and Economic Impacts of the Measure Accurately, Act Rapidly, and Partner with Patients Program to Improve Hypertension Control.

Introduction: This study uses microsimulation to estimate 10-year health and economic outcomes that may be achieved by widely adopting the American Medical Association's Measure Accurately, Act Rapidly, and Partner with Patients hypertension (AMA MAPTM HTN) quality improvement program.

Methods: A microsimulation model was adapted to conduct "what if" analyses for adopting the MAP HTN program nationwide and in care delivery systems of varying size. The analysis was conducted in 2020-2024, and the microsimulation model was constructed using various data sources from 1948 to 2019. Modeled outcomes over 10 years included prevalence of systolic blood pressure (SBP) ≥140 mmHg; incidence of cardiovascular disease (CVD) events and CVD-related mortality; averted medical costs by payer in 2021 U.S. dollars; and net costs.

Results: For patients with hypertension over 10 years, nationwide adoption of the MAP HTN program was predicted to improve mean BP control by 4.3% and prevent 601 thousand CVD events and 120 thousand CVD deaths. Most of the estimated $17.9 billion in averted disease costs were observed in patients with Medicare. Total costs associated with implementing the MAP HTN program totaled $12.6 billion, resulting in a predicted $5.3 billion in net savings to the health care sector over 10 years. Small and large care delivery organizations could economically benefit from implementing the MAP HTN program at varying levels (5-50%) of shared cost savings from payers.

Conclusions: There is promise for quality improvement programs targeting BP management, but more research is needed to affirm the assumptions and findings of this analysis.

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来源期刊
American Journal of Preventive Medicine
American Journal of Preventive Medicine 医学-公共卫生、环境卫生与职业卫生
CiteScore
8.60
自引率
1.80%
发文量
395
审稿时长
32 days
期刊介绍: The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.
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