急性心肌梗塞病患照護連續性與照護結果及醫療費用之關係

Association of Continuity of Care with Healthcare Outcomes and Expenses among Acute Myocardial Infarction Patients

江蕙如(Hui-Ju Chiang)

指導教授 ： 董鈺琪

國立臺灣大學/公共衛生學院/健康政策與管理研究所/碩士(2017年)

https://doi.org/10.6342/NTU201700096

摘要

無資料

關鍵字

急性心肌梗塞 ； 照護連續性 ； 照護結果 ； 醫療費用

並列摘要

Background：Acute myocardial infarction (AMI) patients had high mortality, readmission and healthcare expenses within 1-year after discharge. A previous study indicated that high continuity of care before AMI admission could reduce 1-year post-discharge mortality. According to one study, heart failure patients with higher continuity of care after discharge are associated with better outcomes and lower expenses. However, the association of continuity of care from pre-admission to post-discharge with outcomes and expenses is still unclear.

Objective：This study examined the association of the pre-admission and post-discharge of continuity of care with mortality, readmission and expenses after discharge for AMI patients.

Methods：This study used data from National Health Insurance Research Database and analyzed AMI patients discharged from January 2007 to December 2011. Generalized estimating equation and Cox proportional hazard models with robust sandwich variance estimates were performed to examine the association of outpatient continuity with 1-year all-cause mortality, readmission and expenses of post-discharge care.

Results：High continuity of care after discharge can improve healthcare outcomes and reduce expenses. In contrast with pre-admission, we found increased continuity of care after discharge was significantly associated with a decreased risk of mortality, readmission and expenses.

Conclusions：AMI patients with high continuity of care after discharge have better outcomes and lower expenses. To improve AMI patients’ outcome and control medical expenses after discharge, policy-makers and healthcare providers may adapt continuity of care index for monitoring healthcare quality.

並列關鍵字

Acute myocardial infarction ； continuity of care ； outcomes of care ； healthcare expenses

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