Impact of financial incentives for inter-provider care coordination on health-care resource utilization among elderly acute stroke patients.
Impact of financial incentives for inter-provider care coordination on health-care resource utilization among elderly acute stroke patients.
复制标题
提供者间护理协调的经济激励对老年急性卒中患者医疗资源利用的影响。
DOI：
10.1093/intqhc/mzx053
复制
发表时间：
2017
影响因子：
2.6
通讯作者：
Akira Babazono
中科院分区：
文献类型：
--
作者：
Takumi Nishi;Toshiki Maeda;Akira Babazono
目的探讨提供者之间的护理协调对老年急性脑卒中患者医疗资源利用的影响。设计一项使用医疗保险索赔数据的回顾性队列研究。福冈县广域老年人后期医疗保健协会的SettingClaims数据。2010年4月1日至2015年9月30日，6409例75岁或以上急性卒中患者入住康复病房。主要结局指标住院时间（LOS）和总费用（结果与其他护理路径相比，协调护理组在急性缺血性脑卒中护理中的LOS缩短了2. 0 d，在出血性脑卒中护理中的LOS缩短了2. 5 d，差异有统计学意义（P < 0. 05）。然而，有没有显着差异，在康复护理LOS和TC。ConclusionsOur研究结果表明，支付系统的护理协调是不适当的，因为它是不相关的整体医疗资源利用率的降低。此外，为了提高日本多个医疗机构之间的医疗连续性，需要进行医疗制度改革。
ObjectiveTo examine the impact of inter-provider care coordination on health-care resource utilization among elderly acute stroke patients.DesignA retrospective cohort study using health-care insurance claims data.SettingClaims data of the Fukuoka Prefecture Wide-Area Association of Latter-Stage Elderly Healthcare.ParticipantsAbout, 6409 patients aged 75 years or older admitted for acute stroke and moved to rehabilitation wards from 1 April 2010 to 30 September 2015.Main outcome measureLengths of stay (LOS) and total charge (TC) were evaluated according to three groups of care pathways (coordinated care, integrated care and other pathways).ResultsCompared with the other care pathway, the coordinated care groups had significantly shorter LOS of 2.0 days in acute ischemic stroke care; they had 2.5 days shorter LOS in hemorrhagic stroke care. However, there were no significant differences in rehabilitation care LOS and TC.ConclusionsOur findings suggest that a payment system for care coordination is inappropriate since it was not associated with a reduction in overall health-care resource utilization. Further, health-care system reform is necessary to improve care continuity across multiple health-care institutions in Japan.