期刊
JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE
卷 24, 期 6, 页码 557-563出版社
MARY ANN LIEBERT, INC
DOI: 10.1089/acm.2017.0203
关键词
integrative medicine; outcomes research; pain; electronic health record; costs and cost analysis; inpatients; hospitalization
资金
- National Center for Complementary and Integrative Health (NCCIH) of the National Institutes of Health [AT006518]
Objectives: An important task facing hospitals is improving pain management without raising costs. Integrative medicine (IM), a promising nonpharmacologic pain management strategy, is yet to be examined for its cost implications in an inpatient setting. This institution has had an inpatient IM department for over a decade. The purpose was to examine the relationship between changes in patients' pain, as a result of receiving IM therapy, and total cost of care during an inpatient hospital admission. Design: In this retrospective analysis, data from an EPIC-based electronic health record (EHR) patient demographics, length of stay (LOS), and All Patient Refined Diagnosis Related Groups (APR-DRG) severity of illness measures were utilized. IM practitioners collected and entered patient-reported pain scores into the EHR. The authors regressed the demographic, change in pain, LOS, and APR-DRG variables with changes in pain on total cost for the hospital admission. To estimate cost savings to the hospital, they computed the average reduction in cost associated with reduction in pain by multiplying the coefficient for change in pain by average total cost. Setting/Location: A large, tertiary care hospital in Minneapolis, MN. Subjects: Adult inpatient admissions, 2730, during the study period where patients received IM for pain and met eligibility criteria. Intervention: IM services provided to inpatients. Outcome measures: Change in pain on an 11-point numeric rating scale before and after initial IM sessions; total costs for hospital admissions. Results: Both LOS and age were found to increase cost, as did being white, male, married, and having APR-DRG severity coded as extreme. For patients receiving IM therapies, pain was reduced by an average of 2.05 points and this pain reduction was associated with a cost savings of $898 per hospital admission. Conclusions: For patients receiving IM therapies, pain was significantly reduced and costs were lowered by about 4%.
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