Integrated Telehealth And Care Management Program For Medicare Beneficiaries With Chronic Disease Linked To Savings
Integrated Telehealth And Care Management Program For Medicare Beneficiaries With Chronic Disease Linked To Savings
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DOI：
10.1377/hlthaff.2011.0216
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发表时间：
2011-09-01
期刊：
影响因子：
9.7
通讯作者：
Birnbaum, Howard
中科院分区：
文献类型：
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作者：
Baker, Laurence C.;Johnson, Scott J.;Birnbaum, Howard
慢性病患者的治疗占美国医疗保健支出的近五分之四，但它受到分散的提供系统和不连续的护理的阻碍。我们研究了一种称为健康伙伴计划的护理协调方法的影响，该计划将远程医疗工具与慢性病医疗保险受益人的护理管理相结合。我们评估了该计划对美国西北部两个诊所接受干预的患者支出的影响，并将他们的经验与匹配的对照组进行了比较。我们发现使用Health Buddy远程医疗计划的患者节省了大量费用，每人每季度的支出减少约7.7- 13.3%（312 - 542美元）。这些结果表明，精心设计和实施的护理管理和远程医疗计划可以帮助减少医疗保健支出，这些计划值得医疗保险的持续关注。与此同时，治疗组和对照组的死亡率差异表明，干预可能会对健康结果产生明显的变化，但我们将其留给未来的研究来充分探讨这些影响。
Treatment of chronically ill people constitutes nearly four-fifths of US health care spending, but it is hampered by a fragmented delivery system and discontinuities of care. We examined the impact of a care coordination approach called the Health Buddy Program, which integrates a telehealth tool with care management for chronically ill Medicare beneficiaries. We evaluated the program's impact on spending for patients of two clinics in the US Northwest who were exposed to the intervention, and we compared their experience with that of matched controls. We found significant savings among patients who used the Health Buddy telehealth program, which was associated with spending reductions of approximately 7.7-13.3 percent ($312-$542) per person per quarter. These results suggest that carefully designed and implemented care management and telehealth programs can help reduce health care spending and that such programs merit continued attention by Medicare. Meanwhile, mortality differences in the treatment and control groups suggest that the intervention may have produced noticeable changes in health outcomes, but we leave it to future research to explore these effects fully.