背景:“社区康复计划”(PRADO)COPD是一项家庭出院支持计划,致力于组织COPD加重住院后的护理途径。这项研究旨在评估其医学经济影响。
方法:这是2017年至2019年PRADOBPCO患者的回顾性数据库研究。数据来自国家健康数据系统。使用倾向评分匹配建立对照组。在住院后的一年中测量了Morbi死亡率和费用(从国家健康保险的角度来看)。
结果:虽然PRADO组中符合国家卫生局建议的护理途径的患者比例较高,对死亡率和12个月再住院无显著影响.在普拉多集团,当护理途径最佳时,再住院率较低.PRADO组每位患者的医疗费用高出670欧元。
结论:PRADOCOPD改善了护理质量,但没有降低再住院率和死亡率,尽管受益于最佳治疗途径的PRADO组患者的再住院率确实有所下降.
BACKGROUND: The \"Programme d\'Accompagnement du retour à Domicile\" (PRADO) COPD is a home discharge support program dedicated to organizing care pathways following hospitalization for COPD exacerbation. This study aimed at assessing its medico-economic impact.
METHODS: This was a retrospective database study of patients included in the PRADO BPCO between 2017 and 2019. Data were extracted from the National Health Data System. A control group was built using propensity score matching. Morbi-mortality and costs (national health insurance perspective) were measured during the year following hospitalization.
RESULTS: While the proportion of patients with a care pathway complying with recommendations from the National Health Authority was higher in the PRADO group, there was no significant effect on mortality and 12-month rehospitalization. In the PRADO group, the rehospitalization rate was lower when the care pathway was optimal. Healthcare costs per patient were 670 € higher in the PRADO group.
CONCLUSIONS: The PRADO COPD improves quality of care but without decreasing rehospitalizations and mortality, although rehospitalizations did decrease among PRADO group patients benefiting from an optimal care pathway.