長期的な急性ケア病院利用は,重篤な病気の後の病院利用です
Jeremy M Kahn1, Nicole M Benson, Dina Appleby
1Division of Pulmonary, Allergy, and Critical Care, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Blockley Hall 723, 423 Guardian Dr, Philadelphia, PA 19104, USA. jmkahn@mail.med.upenn.edu
JAMA
|June 10, 2010
まとめ
長期急性ケア病院 (LTAC) の利用は,重症のメディケア受給者の間で全国的に急増しました. 増加した使用にもかかわらず,LTAC移転後の生存率は極めて低いままです.
科学分野:
- ヘルスケア・マネジメント・ヘルスケア・マネジメント
- クリティカルケア・メディシン
- 医療サービス 研究 医療サービス
背景:
- 長期急性ケア病院 (LTAC) は,重症後の回復のための成長するモデルを表しています.
- 現在,LTAC利用の規模と増加に関する国内データは限られている.
研究 の 目的:
- 重症病後の高齢のメディケア受給者におけるLTAC利用のタイムトレンドを調査する.
- LTACに移転した患者の関連費用と生存結果を分析する.
主な方法:
- 遡及的なコホート研究では,1997年から2006年にかけてのメディケアプロバイダー分析およびレビュー (MPAR) データを分析した.
- アメリカ大陸の集中治療室 (ICU) に入院した65歳以上の医療費支給メディケア受給者を含む.
主要な成果:
- LTACは年間8.8%増加し,1997年から2006年の間に入院数は13,732から40,353に増加しました.
- 関連費用は4億8,400万ドルから13億2,500万ドルに増加し,LTACの使用人口の発生率は2倍以上になりました.
- 移送された患者は併発症や機械呼吸器の使用が増加し,1年間の死亡率は高かった (50%以上).
結論:
- 深刻な病気の後のLTACの利用は,メディケア受給者の間で大幅に増加しています.
- 深刻な病気の後にLTACに移送された患者の生存結果は不良であり,さらなる調査と潜在的な介入の必要性を示しています.
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