口服营养补充剂能改善医院医疗保险患者的预后吗?

Q3 Economics, Econometrics and Finance

Forum for Health Economics and Policy Pub Date : 2014-09-01 DOI:10.1515/fhep-2014-0011

D. Lakdawalla, J. Snider, D. Perlroth, C. LaVallee, M. Linthicum, T. Philipson, J. Partridge, P. Wischmeyer

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引用次数: 9

摘要

我们分析了口服营养补充剂(ONS)使用对住院医保患者(≥65岁)30天再入院率、住院时间(LOS)和发作费用的影响，以及诊断为急性心肌梗死(AMI)、充血性心力衰竭(CHF)或肺炎(PNA)患者亚群的影响。倾向得分匹配和工具变量用于分析来自Premier Research Database(2000-2010)的国家统计局和非国家统计局事件。使用ONS与AMI患者30天再入院概率降低12.0%和CHF患者降低10.1%相关。AMI患者的LOS降低10.9%，CHF患者的LOS降低14.2%，PNA患者的LOS降低8.5%与ONS相关，AMI、CHF和PNA患者的发作成本分别降低5.1%、7.8%和10.6%。对任意诊断人群的LOS和发作费用的影响最大，分别下降了16.0%和15.8%。在65岁以上的住院医疗保险患者中使用ONS与改善预后和降低医疗成本相关，因此与寻求廉价、循证方法以满足《平价医疗法案》质量目标的提供者相关。

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Can Oral Nutritional Supplements Improve Medicare Patient Outcomes in the Hospital?

Abstract We analyzed the effect of oral nutritional supplement (ONS) use on 30-day readmission rates, length of stay (LOS), and episode costs in hospitalized Medicare patients (≥65), and subsets of patients diagnosed with acute myocardial infarction (AMI), congestive heart failure (CHF) or pneumonia (PNA). Propensity-score matching and instrumental variables were used to analyze ONS and non-ONS episodes from the Premier Research Database (2000–2010). ONS use was associated with reductions in probability of 30-day readmission by 12.0% in AMI and 10.1% in CHF. LOS decreases of 10.9% in AMI, 14.2% in CHF, and 8.5% in PNA were associated with ONS, as were decreases in episode costs in AMI, CHF and PNA of 5.1%, 7.8% and 10.6%, respectively. The effect on LOS and episode cost was greatest for the Any Diagnosis population, with decreases of 16.0% and 15.8%, respectively. ONS use in hospitalized Medicare patients ≥65 is associated with improved outcomes and decreased healthcare costs, and is therefore relevant to providers seeking an inexpensive, evidence-based approach for meeting Affordable Care Act quality targets.

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来源期刊

Forum for Health Economics and Policy Economics, Econometrics and Finance-Economics, Econometrics and Finance (miscellaneous)

CiteScore

1.60

自引率

0.00%

发文量

期刊介绍： Forum for Health Economics & Policy (FHEP) showcases articles in key substantive areas that lie at the intersection of health economics and health policy. The journal uses an innovative structure of forums to promote discourse on the most pressing and timely subjects in health economics and health policy, such as biomedical research and the economy, and aging and medical care costs. Forums are chosen by the Editorial Board to reflect topics where additional research is needed by economists and where the field is advancing rapidly. The journal is edited by Katherine Baicker, David Cutler and Alan Garber of Harvard University, Jay Bhattacharya of Stanford University, Dana Goldman of the University of Southern California and RAND Corporation, Neeraj Sood of the University of Southern California, Anup Malani and Tomas Philipson of University of Chicago, Pinar Karaca Mandic of the　University of Minnesota, and John Romley of the University of Southern California. FHEP is sponsored by the Schaeffer Center for Health Policy and Economics at the University of Southern California. A subscription to the journal also includes the proceedings from the National Bureau of Economic Research''s annual Frontiers in Health Policy Research Conference. Topics: Economics, Political economics, Biomedical research and the economy, Aging and medical care costs, Nursing, Cancer studies, Medical treatment, Others related.