The effects of social support and education on health care costs after three years.
The effects of social support and education on health care costs after three years.
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三年后社会支持和教育对医疗保健费用的影响。
DOI：
10.1002/art.1790110504
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
Tomita,M
中科院分区：
文献类型：
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作者：
Cronan,TA;Hay,M;Groessl,E;Bigatti,S;Gallagher,R;Tomita,M
Objective.为了确定实验性开发的社会支持，关于适当使用医疗保健系统的教育及其组合是否能有效降低骨关节炎患者3年随访评估的医疗保健费用。363名患有骨关节炎的健康维护组织成员被随机分配到3个干预组中的1个或对照组。256名参与者完成了3年评估。健康状况和医疗保健的使用进行了评估后，进入研究，并在1，2和3年。在第3年，联合实验组的医疗保健费用比对照组低1，279美元/参与者/年。参与者进入研究和第3年评估之间的健康状况没有显著变化。3种干预措施对健康状况和医疗保健费用的影响几乎相同。社会支持干预的实施成本最低，但教育和社会支持相结合的干预组的流失率更低，持续性更强。以适当利用卫生保健系统为目标的干预措施可以具有很高的成本效益，而不会对健康状况产生不利影响。
Objective. To determine whether experimentally developed social support, education about appropriate use of the health care system, and their combination are effective in reducing health care costs for people with osteoarthritis at a 3‐year followup assessment.Method. Three hundred sixty‐three health maintenance organization members with osteoarthritis were randomly assigned to 1 of 3 intervention groups or to a control group. Two hundred fifty‐six participants completed the 3‐year assessment. Health status and health care use were assessed upon entering the study, and after 1, 2, and 3 years.Results. Health care costs in the combined experimental groups were lower than those in the control group by $1,279/participant/year in year 3. There were no significant changes in health status between participants' entry into the study and the year 3 assessment. The 3 interventions had nearly equal effects on health status and health care costs. Implementation costs were least for the social support intervention, but the group that combined education and social support had less attrition and greater persistence.Conclusion. Interventions that target appropriate use of the health care system can be highly costeffective without adversely affecting health status.