Improving the management of care for high-cost medicaid patients
Improving the management of care for high-cost medicaid patients
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DOI：
10.1377/hlthaff.26.6.1643
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发表时间：
2007-11-01
期刊：
影响因子：
9.7
通讯作者：
Mijanovich, Tod
中科院分区：
文献类型：
--
作者：
Billings, John;Mijanovich, Tod
越来越多的政策关注集中在医疗补助中高成本病例的管理上。在本文中，我们提出了一种算法，确定患者在未来住院的高风险，并提供了一个商业案例分析与一系列的假设减少未来住院率和干预的成本。描述了由算法识别的患者的特征，并讨论了这些发现对决策者，付款人和有兴趣更有效地响应这些患者需求的提供者的影响，包括在实施干预措施时可能遇到的挑战。
Increased policy attention is being focused on the management of high-cost cases in Medicaid. In this paper we present an algorithm that identifies patients at high risk of future hospitalizations and offer a business-case analysis with a range of assumptions about the rate of reduction in future hospitalization and the cost of the intervention. The characteristics of the patients identified by the algorithm are described, and the implications of these findings for policymakers, payers, and providers interested in responding more effectively to the needs of these patients are discussed, including the challenges likely to be encountered in implementing an intervention initiative.