Comparison of End of Life Costs Between Managed Care and Fee for Service

管理式医疗与服务费之间的生命终期成本比较

• 批准号: 6227903
• 负责人: ezekiel J emanuel
• 金额: --
• 依托单位: CLINICAL CENTER
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/6227903
• 关键词: Medicare /Medicaid; age difference; death; health care cost /financing; health care service utilization; health services research tag; home health care; hospices; hospital patient care; human data; human middle age (35-64); human old age (65+); managed care; terminal patient care

This study is designed (1) to determine the comparative costs and resources utilization over the last year of life for patients treated by managed care, fee-for-service, and Medicare, (2) to compare sites of death, (3) to compare utilization of hospice and hospital beds, and (4) to compare care provided to those over 65 and those under 65. A full set of data has been obtained from two managed care companies and from Medicare. Some problems with the data sets are that use of hospice is not fully recorded in one data set and hospitalization prior to death is not fully recorded in another. However, preliminary observations indicate (1) no difference between managed care and fee for service in site of death (i.e., hospital versus home) and (2) managed care has a slightly higher proportion of cancer deaths than deaths from heart disease. Full results are expected within the next 12 months.

本研究旨在（1）确定接受管理式护理、按服务收费和医疗保险治疗的患者生命最后一年的比较成本和资源利用率，（2）比较死亡地点，（3）比较临终关怀和医院床位的利用率，（4）比较65岁以上和65岁以下患者的护理。从两家管理式医疗公司和医疗保险公司获得了一整套数据。数据集的一些问题是，一个数据集没有充分记录临终关怀的使用情况，另一个数据集没有充分记录死亡前的住院情况。然而，初步观察表明（1）管理式护理和死亡现场服务费之间没有区别（即，医院与家庭）和（2）管理式护理的癌症死亡比例略高于心脏病死亡比例。预计在未来12个月内将得出全面结果。