Earlier Pediatric Psychology Consultation Predicts Lower Stem Cell Transplantation Hospital Costs.
Earlier Pediatric Psychology Consultation Predicts Lower Stem Cell Transplantation Hospital Costs.
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早期的儿科心理咨询预计干细胞移植医院费用会降低。
DOI：
10.1093/jpepsy/jsx124
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发表时间：
2018
影响因子：
3.6
通讯作者：
Pai,AhnaLH
中科院分区：
文献类型：
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作者：
McGrady,MeghanE;Joffe,NaomiE;Pai,AhnaLH
本研究的目的是检验这一假设，即在儿童医院接受治疗的患者中，早期心理咨询可以预测初始干细胞移植（SCT）住院治疗的成本较低。（年龄0-32岁），在2010年至2014年的首次SCT住院期间，有一名或多名有执照的临床心理学家进行了一次或多次访视。从电子病历中获得人口统计学和临床变量，从患者账单记录中获得住院费用。一个广义线性模型与伽玛分布和对数链接函数被用来估计心理咨询的时间和成本之间的关系，为首次SCT住院，同时控制人口统计学，临床和利用factors.ResultsAfter控制年龄在SCT，性别，种族，保险状态，诊断，SCT类型，住院时间，和心理访问次数，心理咨询时间越早，SCT首次住院费用越低（χ2= 6.83，p = 0.01）。当协变量的影响保持不变，每天增加心理咨询的时间与SCT住院费用增加0.3%（β = 0.003，SE = 0.001）。结论结果表明，促进咨询与儿科心理学家在最初的SCT住院可能会降低成本接受SCT的患者在儿童医院。未来的研究需要确定心理咨询的最佳时机，并量化心理服务的经济影响。
ObjectiveThe purpose of this study was to examine the hypothesis that earlier time to psychology consultation would predict lower costs for the initial stem cell transplant (SCT) hospitalization among patients receiving care at a children’s hospital.MethodsA retrospective medical record review identified 75 patients (ages 0–32 years) with one or more visits by a licensed clinical psychologist during the initial SCT hospitalization from 2010 to 2014. Demographic and clinical variables were obtained from the electronic medical record and hospitalization costs were obtained from patient billing records. A generalized linear model with a gamma distribution and log link function was used to estimate the relationship between time to psychology consultation and cost for the initial SCT hospitalization while controlling for demographic, clinical, and utilization factors.ResultsAfter controlling for age at SCT, gender, race, insurance status, diagnosis, SCT type, length of stay, and number of psychology visits, earlier time to psychology consultation predicted lower costs for the initial SCT hospitalization (χ2= 6.83,p= .01). When the effects of covariates were held constant, every day increase in the time to psychology consultation was associated with a 0.3% increase in SCT hospitalization costs (β = 0.003, SE = 0.001).ConclusionsResults suggest that facilitating consultations with a pediatric psychologist early in the initial SCT hospitalization may reduce costs for patients undergoing SCT at children’s hospitals. Future research is needed to determine the optimal timing of psychology consultation and quantify the economic impact of psychological services.