Cost analysis of a home-based nurse care coordination program.
Cost analysis of a home-based nurse care coordination program.
复制标题
DOI：
10.1111/jgs.13162
复制
发表时间：
2014-12
影响因子：
6.3
通讯作者：
Colorafi KJ
中科院分区：
文献类型：
--
作者：
Marek KD;Stetzer F;Adams SJ;Bub LD;Schlidt A;Colorafi KJ
确定以药物自我管理为重点的家庭护理协调计划是否会影响医疗保险计划的护理成本，以及增加技术（配药机）是否会进一步降低成本。随机、对照、三臂纵向研究。参与者的家位于中西部大城市地区。被确定在从 Medicare 家庭医疗保健机构出院时难以管理其药物的老年人 (N = 414)。由高级执业护士 (APN) 和注册护士 (RN) 组成的团队负责协调两组护理：家庭护士护理协调 (NCC) 加药丸组织组和 NCC 加配药机组。为了衡量成本，从 Medicare A 部分和 B 部分标准分析文件中检索了 2005 年至 2011 年的参与者索赔数据。使用协变量调整的普通最小二乘回归来估计每月节省的资金。 NCC 加药丸组织者组的医疗保险总费用每月比接受常规护理的对照组低 447 美元 (P = .11)。对于参与研究至少 3 个月的参与者来说，NCC 加药丸组织者组每月的医疗保险总费用比对照组低 491 美元 (P = .06)。 NCC 加上药丸组织者干预的成本为每月 151 美元，每月净节省 296 美元或每年 3,552 美元。 NCC 加配药机干预的费用为每月 251 美元，医疗保险总费用比 NCC 加药丸组织者组每月高出 409 美元。对于体弱的老年医疗保险受益人来说，护士护理协调加上药丸整理器是一种经济有效的干预措施。添加药物机并没有提高干预措施的成本效益。
To determine whether a home-based care coordination program focused on medication self-management would affect the cost of care to the Medicare program and whether the addition of technology, a medication-dispensing machine, would further reduce cost. Randomized, controlled, three-arm longitudinal study. Participant homes in a large Midwestern urban area. Older adults identified as having difficulty managing their medications at discharge from Medicare Home Health Care (N = 414). A team consisting of advanced practice nurses (APNs) and registered nurses (RNs) coordinated care for two groups: home-based nurse care coordination (NCC) plus a pill organizer group and NCC plus a medication-dispensing machine group. To measure cost, participant claims data from 2005 to 2011 were retrieved from Medicare Part A and B Standard Analytical Files. Ordinary least squares regression with covariate adjustment was used to estimate monthly dollar savings. Total Medicare costs were $447 per month lower in the NCC plus pill organizer group (P = .11) than in a control group that received usual care. For participants in the study at least 3 months, total Medicare costs were $491 lower per month in the NCC plus pill organizer group (P = .06) than in the control group. The cost of the NCC plus pill organizer intervention was $151 per month, yielding a net savings of $296 per month or $3,552 per year. The cost of the NCC plus medication-dispensing machine intervention was $251 per month, and total Medicare costs were $409 higher per month than in the NCC plus pill organizer group. Nurse care coordination plus a pill organizer is a cost-effective intervention for frail elderly Medicare beneficiaries. The addition of the medication machine did not enhance the cost effectiveness of the intervention.
登录
查看更多内容
影响因子：
158.5
作者：
Cohen, HJ;Feussner, JR;Brodkin, K
通讯作者：
Brodkin, K
DOI：
10.1111/j.1532-5415.1990.tb01373.x
发表时间：
1990-10-01
影响因子：
6.3
作者：
REUBEN, DB;SIU, AL
通讯作者：
SIU, AL
影响因子：
2.5
作者：
Marek, Karen Dorman;Stetzer, Frank;O'Brien, Anne-Marie
通讯作者：
O'Brien, Anne-Marie
DOI：
10.1093/gerona/63.3.321
发表时间：
2008-03-01
影响因子：
5.1
作者：
Boult, Chad;Reider, Lisa;Scharfstein, Daniel
通讯作者：
Scharfstein, Daniel
DOI：
10.1046/j.1532-5415.2001.49076.x
发表时间：
2001-04-01
影响因子：
6.3
作者：
Boult, C;Boult, LB;Urdangarin, CF
通讯作者：
Urdangarin, CF