アメリカの病院における教員の地位と死亡率との関連
Laura G Burke1, Austin B Frakt2, Dhruv Khullar3
1Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts2Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
JAMA
|May 24, 2017
まとめ
大手教科病院では,非教科病院と比較して,メディケア患者の死亡率が低いことが示されました. これらの発見は,学術医療センターでの治療の潜在的な利点を強調しています.
科学分野:
- 医療サービス研究
- 比較効果の研究
- 病院 の 質 の 向上
背景:
- 米国の教科病院と非教科病院を比較する患者のアウトカムに関する現在のデータは限られている.
- これらの違いを理解することは 医療政策と患者のケアに関する決定に 極めて重要です
研究 の 目的:
- リスク調整したアウトカム,特に死亡率を比較するために,教養病院と非教養病院に入院した患者.
- この研究では,メディケア受給者の幅広い医療および外科的状態を調査した.
主な方法:
- アメリカ全土の病院で 2100万件以上の入院を 対象とした医療保険のデータです
- 主要な教科,次要の教科,非教科の病院を分類しました.
- 患者と病院の特徴を調整して,30日間の死亡率を主な結果として分析した.
主要な成果:
- 主要な教科病院では,非教科病院と比較して,調整されていないおよび調整された30日間の死亡率が低いことが示されました.
- この生存効果は,様々な病院 (大,中,小) で観察されました.
- 具体的には 大規模な大手教科病院は 大規模な非教科病院よりも 1.2%低い調整された死亡率でした
結論:
- 大手教科病院の地位はメディケア受給者の死亡率を大幅に低下させる.
- これらの発見は,学術医療センターでの患者の成果に潜在的な利点を示唆しています.
- 死亡率の差異に寄与する特定の要因を明らかにするためにさらなる研究が必要である.
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