Redesigning Care For Patients At Increased Hospitalization Risk: The Comprehensive Care Physician Model
Redesigning Care For Patients At Increased Hospitalization Risk: The Comprehensive Care Physician Model
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DOI：
10.1377/hlthaff.2014.0072
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发表时间：
2014-05-01
期刊：
影响因子：
9.7
通讯作者：
Ruhnke, Gregory W.
中科院分区：
文献类型：
--
作者：
Meltzer, David O.;Ruhnke, Gregory W.
住院的患者经常遇到护理协调问题，使结果恶化并增加成本。原因之一是医院护理和门诊护理通常由不同的医生提供。然而，改善住院患者护理协调的干预措施并没有持续改善结果，而且通常也没有降低成本。我们描述了综合护理医生模式的基本原理，在该模式中，医生将他们的实践集中在住院风险增加的患者身上，以便他们可以为患者提供住院和门诊护理。我们还描述了医疗保险和医疗补助创新中心支持的一项研究的设计和实施，以评估该模型对成本和结果的影响。预计到2016年将获得有关该方案有效性的证据。如果该计划被认为是有效的，下一步将是评估其效益的持久性和模型的传播潜力;相反的证据将提供如何改变计划，以解决失败的根源的见解。
Patients who have been hospitalized often experience care coordination problems that worsen outcomes and increase costs. One reason is that hospital care and ambulatory care are often provided by different physicians. However, interventions to improve care coordination for hospitalized patients have not consistently improved outcomes and generally have not reduced costs. We describe the rationale for the Comprehensive Care Physician model, in which physicians focus their practice on patients at increased risk of hospitalization so that they can provide both inpatient and outpatient care to their patients. We also describe the design and implementation of a study supported by the Center for Medicare and Medicaid Innovation to assess the model's effects on costs and outcomes. Evidence concerning the effectiveness of the program is expected by 2016. If the program is found to be effective, the next steps will be to assess the durability of its benefits and the model's potential for dissemination; evidence to the contrary will provide insights into how to alter the program to address sources of failure.