A Nurse Navigator Program Is Effective in Reducing Episode-of-Care Costs Following Primary Hip and Knee Arthroplasty
A Nurse Navigator Program Is Effective in Reducing Episode-of-Care Costs Following Primary Hip and Knee Arthroplasty
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DOI：
10.1016/j.arth.2019.04.062
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发表时间：
2019-08-01
影响因子：
3.5
通讯作者：
Courtney, P. Maxwell
中科院分区：
文献类型：
--
作者：
Phillips, Jessica L. H.;Rondon, Alexander J.;Courtney, P. Maxwell
背景：全髋关节置换术（THA）和全膝关节置换术（TKA）的替代支付模式激励提供者以更低的成本提供更高质量的护理，促使一些机构开发正式的护士导航计划（nnp）。本研究的目的是确定原发性THA和TKA的NNP是否会降低护理费用（EOC）。方法：我们回顾了2015-2016年连续的一系列原发性THA和TKA患者，使用来自医疗保险和医疗补助服务中心的索赔数据以及来自私营保险公司的医疗保险优势患者。聘请了三名护士导航员指导出院处理和家庭需求。在NNP实施前后收集了90天EOC费用。为了控制混杂变量，我们进行了多变量回归分析，以确定NNP对EOC成本的独立影响。结果：在研究期间，5275例患者接受了原发性TKA或THA。与prenavigator组的患者相比，NNP组减少了90天的EOC费用(19,116美元对20,418美元的医疗保险，35,378美元对36,961美元的私人付款人，P
Background: Alternative payment models for total hip arthroplasty (THA) and total knee arthroplasty (TKA) have incentivized providers to deliver higher quality care at a lower cost, prompting some institutions to develop formal nurse navigation programs (NNPs). The purpose of this study was to determine whether a NNP for primary THA and TKA resulted in decreased episode-of-care (EOC) costs.Methods: We reviewed a consecutive series of primary THA and TKA patients from 2015-2016 using claims data from the Centers for Medicare and Medicaid Services and Medicare Advantage patients from a private insurer. Three nurse navigators were hired to guide discharge disposition and home needs. Ninety-day EOC costs were collected before and after implementation of the NNP. To control for confounding variables, we performed a multivariate regression analysis to determine the independent effect of the NNP on EOC costs.Results: During the study period, 5275 patients underwent primary TKA or THA. When compared with patients in the prenavigator group, the NNP group had reduced 90-day EOC costs ($19,116 vs $20,418 for Medicare and $35,378 vs $36,961 for private payer, P