Vermont's Blueprint For Medical Homes, Community Health Teams, And Better Health At Lower Cost
Vermont's Blueprint For Medical Homes, Community Health Teams, And Better Health At Lower Cost
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DOI：
10.1377/hlthaff.2011.0169
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发表时间：
2011-03-01
期刊：
影响因子：
9.7
通讯作者：
Bielaszka-DuVernay, Christina
中科院分区：
文献类型：
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作者：
Bielaszka-DuVernay, Christina
系统佛蒙特州健康蓝图是一个全州性的公私合作计划，旨在改变医疗服务，改善健康结果，使该州的每个人都能获得无缝、协调良好的医疗服务。关键创新让社区卫生团队与初级保健提供者合作，评估患者的需求，协调以社区为基础的支持服务，并为普通人群提供多学科护理。成本节约最近对第一个试点项目的分析发现，住院人数和急诊就诊人数及其相关的人均每月成本同比大幅下降。一旦全面的财政改革到位，预计将进一步节省资金。当在全州范围内推出时，该计划预计将节省28.7%的增量卫生支出在其第五年的状态。质量改进结果一个定性评估的试点网站表明，供应商和患者的价值的作用，社区卫生团队在连接患者的行为健康，慢性病护理管理和社会服务支持。客观的评估表明，早期的临床质量和使用的改善，如更好地控制高血压。挑战对于主动是财政上成功的，必须有一个可避免的急诊科就诊和住院可测量的减少。保险公司必须将支出从远程呼叫中心、疾病管理和邮寄转移到对社区卫生团队的支持上。
SYSTEM The Vermont Blueprint for Health is a statewide public-private initiative to transform care delivery, improve health outcomes, and enable everyone in the state to receive seamless, well-coordinated care.KEY INNOVATION Having community health teams work with primary care providers to assess patients' needs, coordinate community-based support services, and provide multidisciplinary care for a general population. A web-based central health registry will capture all patient data.COST SAVINGS A recent analysis of the first pilot program found significant year-over-year decreases in hospital admissions and emergency department visits, and their related per person per month costs. Further savings are forecast once comprehensive financial reform is in place. When rolled out statewide, the initiative is projected to save 28.7 percent in incremental health spending in the state by its fifth year.QUALITY IMPROVEMENT RESULTS A qualitative assessment of pilot sites suggests that providers and patients value the role of community health teams in connecting patients with behavioral health, chronic care management, and social services support. Objective assessments suggest early improvements in clinical quality and use, such as better control of hypertension.CHALLENGES For the initiative to be financially successful, there must be a measurable reduction in avoidable emergency department visits and hospitalizations. Insurers must shift spending away from remote call centers, disease management, and mailings, and into support for community health teams.