Coordination Program Reduced Acute Care Use And Increased Primary Care Visits Among Frequent Emergency Care Users
Coordination Program Reduced Acute Care Use And Increased Primary Care Visits Among Frequent Emergency Care Users
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DOI：
10.1377/hlthaff.2017.0612
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发表时间：
2017-10-01
期刊：
影响因子：
9.7
通讯作者：
Wiler, Jennifer L.
中科院分区：
文献类型：
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作者：
Capp, Roberta;Misky, Gregory J.;Wiler, Jennifer L.
急诊科(ED)的许多高利用率者都有公共保险，特别是通过医疗补助。我们评估了参与护理桥梁(B2C)是如何影响公共保险或符合医疗补助条件的高ED利用率者随后的ED使用、住院和初级保健使用的。B2C是ED发起的、多学科的、基于社区的计划。在B2C干预完成后的6个月里，与对照组患者相比，参与者去急诊室就诊的次数明显减少(减少27.9%)，而去看初级保健的次数明显增加(增加114.0%)。在对患有精神健康合并症的患者进行的子分析中，我们发现，与对照组的患者相比，接受B2C服务的患者急诊就诊(减少29.7%)和住院治疗(30.0%)显著减少，而初级保健就诊显著增加(增加123.2%)。B2C计划减少了急性护理的使用，并增加了高ED利用率者的初级保健就诊次数，包括那些患有精神健康合并症的人。
Many high utilizers of the emergency department (ED) have public insurance, especially through Medicaid. We evaluated how participation in Bridges to Care (B2C)-an ED-initiated, multidisciplinary, community-based program-affected subsequent ED use, hospital admissions, and primary care use among publicly insured or Medicaid-eligible high ED utilizers. During the six months after the B2C intervention was completed, participants had significantly fewer ED visits (a reduction of 27.9 percent) and significantly more primary care visits (an increase of 114.0 percent), compared to patients in the control group. In a subanalysis of patients with mental health comorbidities, we found that recipients of B2C services had significantly fewer ED visits (a reduction of 29.7 percent) and hospitalizations (30.0 percent), and significantly more primary care visits (an increase of 123.2 percent), again compared to patients in the control group. The B2C program reduced acute care use and increased the number of primary care visits among high ED utilizers, including those with mental health comorbidities.