Nutritionist Visits, Diabetes Classes, and Hospitalization Rates and Charges
Nutritionist Visits, Diabetes Classes, and Hospitalization Rates and Charges
复制标题
营养师就诊、糖尿病课程以及住院费用和费用
作者：
J. Robbins;G. Thatcher;D. Webb;V. Valdmanis
目的：我们评估了八个费城卫生保健中心(PHC)(公共安全网初级保健诊所)对糖尿病患者进行的不同类型的教育访问与宾夕法尼亚州卫生保健成本控制委员会报告的住院率和费用的相关性。研究设计和方法--研究人群包括18,404名在1993年3月1日至2001年12月31日期间就诊并被诊断为糖尿病且至少有1个月随访时间的患者。结果--队列中的7839名(42.6%)患者共记录了31,657次住院治疗。在调整了人口统计变量、基线并存情况、糖尿病诊断前的住院次数和其他初级保健就诊次数后，有过任何类型的教育访问的患者每100人年住院次数减少9.18次(95%可信区间5.02-13.33)，人均住院费用减少11,571美元(6,377美元至16,765美元)。每次去看营养师，每100人年住院次数减少4.70次(2.23-7.16)，总住院费用减少6,503美元(3,421-9,586美元)。结论：任何类型的教育访问都与较低的住院率和费用相关。与糖尿病课程相比，去看营养师与减少住院率有更强的相关性。每一次去看营养师都与医院费用的大幅降低有关，这表明在初级保健环境中提供这些服务对卫生保健系统来说可能是非常划算的。
OBJECTIVE—We evaluated the association of different types of educational visits for diabetic patients of the eight Philadelphia Health Care Centers (PHCCs) (public safety-net primary care clinics), with hospital admission rates and charges reported to the Pennsylvania Health Care Cost Containment Council. RESEARCH DESIGN AND METHODS—The study population included 18,404 patients who had a PHCC visit with a diabetes diagnosis recorded between 1 March 1993 and 31 December 2001 and had at least 1 month follow-up time. RESULTS—A total of 31,657 hospitalizations were recorded for 7,839 (42.6%) patients in the cohort. After adjustment for demographic variables, baseline comorbid conditions, hospitalizations before the diabetes diagnosis, and number of other primary care visits, having had any type of educational visit was associated with 9.18 (95% CI 5.02–13.33) fewer hospitalizations per 100 person-years and $11,571 ($6,377 to $16,765) less in hospital charges per person. Each nutritionist visit was associated with 4.70 (2.23–7.16) fewer hospitalizations per 100 person-years and a $6,503 ($3,421 to $9,586) reduction in total hospital charges. CONCLUSIONS—Any type of educational visit was associated with lower hospitalization rates and charges. Nutritionist visits were more strongly associated with reduced hospitalizations than diabetes classes. Each nutritionist visit was associated with a substantial reduction in hospital charges, suggesting that providing these services in the primary care setting may be highly cost-effective for the health care system.
不同种族低收入糖尿病患者队列的入院率：城市糖尿病研究。
影响因子：
12.7
作者：
Robbins,JessicaM;Webb,DavidA
通讯作者：
Webb,DavidA