研究表明，对患者进行强化治疗并不会减少他们的再发病次数

研究表明，对患者进行强化治疗并不会减少他们的再发病次数

Improving health and lowering costs for the sickest and most expensive patients in America is a dream harder to realize than many health care leaders had hoped, according to a study published Wednesday in the New England Journal of Medicine.

周三发表在《新英格兰医学杂志》上的一项研究显示，为美国病情最重、费用最高的患者改善健康、降低费用，是一个比许多医疗保健领导人所希望的更难实现的梦想。

Researchers tested whether pairing frequently hospitalized patients in Camden, N.J., with nurses and social workers could stop that costly cycle of readmissions. The study found no effect: Patients receiving extra support were just as likely to return to the hospital within 180 days as those not receiving that help.

研究人员测试了新泽西州卡姆登经常住院的患者与护士和社会工作者配对是否可以阻止代价高昂的再次住院周期。研究发现没有任何影响：接受额外照顾的患者与没有接受照顾的患者在180天内返回医院的可能性一样大。

The results are a blow to Dr. Jeffrey Brenner and the Camden Coalition of Healthcare Providers, the organization he founded nearly 20 years ago.

这一结果对杰弗里·布伦纳博士和他在近20年前创建的医疗服务提供者卡姆登联盟是一个打击。

"It's my life's work. So, of course, you're upset and sad," says Brenner, who now does similar work with health insurance giant UnitedHealthcare.

“这是我毕生的工作。所以，当然，你会感到沮丧和悲伤，”布伦纳说，他现在医疗保险巨头联合医疗集团也做着类似的工作。

The model of care, pioneered in part by Brenner and profiled in a widely read 2011 article in The New Yorker, has inspired dozens of similar projects across the country and attracted millions in philanthropic funding.

这种护理模式在一定程度上是由布伦纳首创的，并在2011年《纽约客》的一篇广为流传的文章中进行了介绍。这种模式已经激励了全国数十个类似的项目，并吸引了数百万美元的慈善资金。

"This is the messy thing about science," says Brenner, who won a MacArthur Foundation "Genius Grant" for his efforts. "Sometimes things work the way you want them to work and sometimes they don't."

“这就是科学的混乱之处，”布伦纳说，他因自己的努力获得了麦克阿瑟基金会的“天才奖”。“有时事情会按照你希望的方式进行，有时又不会。”

Many hospital and insurance executives have pinned their hopes on this research because it promised to solve a common problem: when patients' lives are so complicated by social factors like poverty and addiction that their manageable medical conditions, like diabetes and asthma, lead to expensive, recurring hospital stays.

许多医院和保险业高管将希望寄托在这项研究上，因为它有望解决一个普遍的问题：当患者的生活因贫困和成瘾等社会因素而变得如此复杂时，他们的糖尿病和哮喘等可控的医疗状况会导致昂贵的反复住院费用。

Brenner's prescription: Pair these patients with front-line care workers who would shepherd them to the social and medical services they needed. Brenner boiled the model's potential down to eight words: better care, lower costs.

布伦纳的处方：将这些患者与一线护理人员配对，后者将引导他们获得所需的社会和医疗服务。布伦纳将该模式的潜力归结为八个字：护理越好，成本越低。

As word spread, breathless headlines popped up like "Health Care's Best Hope," and "Could Camden Coalition Save U.S. Health Care?"

随着消息的传播，像“医疗保健的最大希望”和“卡姆登联盟能拯救美国医疗保健吗?”这样令人屏息的头条新闻层出不穷。

"Lots of organizations make claims that their programs work and they've never been rigorously tested," Brenner says.

布伦纳说:“许多组织声称他们的程序是有效的，但他们从来没有经过严格的测试。”

Instead, Brenner took the unusual step of inviting the scrutiny of respected researchers.

相反，布伦纳采取了不同寻常的步骤，邀请受人尊敬的研究人员进行详细审查。

And the result: The 400 patients who received the intensive help were just as likely to return to the hospital as the patients who didn't. In both groups, nearly two-thirds of people were readmitted within 180 days.

结果是:接受强化治疗的400名患者和没有接受强化治疗的患者一样有可能返回医院。在两组中，近三分之二的人在180天内再次入院。