Mobile Health Care Operations and Return on Investment in Predominantly Underserved Children with Asthma: The Breathmobile Program
Mobile Health Care Operations and Return on Investment in Predominantly Underserved Children with Asthma: The Breathmobile Program
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DOI：
10.1089/pop.2012.0060
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发表时间：
2013-08-01
影响因子：
2.5
通讯作者：
Jones, Craig A.
中科院分区：
文献类型：
--
作者：
Morphew, Tricia;Scott, Lyne;Jones, Craig A.
服务不足的人群获得护理的机会有限。改善获得有效哮喘护理的机会可能会提高生活质量，并降低急诊科(ED)就诊的成本。这项研究的目的是检验呼吸移动计划的投资回报(ROI)在改善患者质量、调整后的寿命年节省和2010年因可预防的急诊室就诊而减少的成本方面，并推算到前几年的操作。它还检查了2008-2009年间参与呼吸运动计划的新患者的与降低发病率(ED就诊、住院和缺课)相关的成本效益。这是一项对15,986名儿科患者的数据的回顾分析，涵盖88,865次访问，参与了4个南加州呼吸移动计划(1995年11月16日至2010年12月31日)。ROI计算将成本-收益比表示为净收益(避免的ED成本+节省的质量调整寿命年的相对价值)除以每年计划成本(类似于每个移动设备500,000美元)。2010年，加州4个项目的投资回报率为每1美元6.73美元。这4个地区避免的年度紧急费用估计数为2541639美元。经质量调整后节省的寿命年的相对价值为24,381,000美元。对于2008-2009年间首次参加呼吸运动计划的患者，他们从事护理(=3次就诊)，每位患者每年避免的总发病率成本为1395美元。这项研究表明，移动医疗是向服务不足的人群提供医疗服务的一种具有成本效益的战略，与治疗的三重目标一致。(《人口健康管理》2013；16：261-269)
Underserved populations have limited access to care. Improved access to effective asthma care potentially improves quality of life and reduces costs associated with emergency department (ED) visits. The purpose of this study is to examine return on investment (ROI) for the Breathmobile Program in terms of improved patient qualityadjusted life years saved and reduced costs attributed to preventable ED visits for 2010, with extrapolation to previous years of operation. It also examines cost-benefit related to reduced morbidity (ED visits, hospitalizations, and school absenteeism) for new patients to the Breathmobile Program during 2008-2009 who engaged in care (>= 3 visits). This is a retrospective analysis of data for 15,986 pediatric patients, covering 88,865 visits, participating in 4 Southern California Breathmobile Programs (November 16, 1995-December 31, 2010). The ROI calculation expressed the cost-benefit ratio as the net benefits (ED costs avoided + relative value of quality-adjusted life years saved) over the per annum program costs (similar to$500,000 per mobile). The ROI across the 4 California programs in 2010 was $6.73 per dollar invested. Annual estimated emergency costs avoided in the 4 regions were $2,541,639. The relative value of quality-adjusted life years saved was $24,381,000. For patients new to the Breathmobile Program during 2008-2009 who engaged in care (>= 3 visits), total annual morbidity costs avoided per patient were $1395. This study suggests that mobile health care is a cost-effective strategy to deliver medical care to underserved populations, consistent with the Triple Aims of Therapy. (Population Health Management 2013;16:261-269)