长期急性护理医院在危急疾病后的使用率
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
概括
长期急症护理医院 (LTACs) 的使用在严重病的医疗保险受益者中全国激增. 尽管使用量增加,但LTAC转移后的生存率仍然非常低.
科学领域:
- 医疗保健管理的管理
- 关键护理医学 关键护理医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 长期急症护理医院 (LTACs) 代表着一个日益增长的病后复苏模式.
- 目前,关于LTAC利用程度和增长的国家数据有限.
研究的目的:
- 调查严重疾病后老年医疗保险受益人中LTAC使用的时间趋势.
- 分析转移到LTACs的患者的相关成本和生存结果.
主要方法:
- 一项回顾性队列研究分析了从1997年到2006年的医疗保险提供者分析和审查 (MPAR) 数据.
- 包括65岁以上的收费医疗保险受益者,他们被送往美国大陆的重症监护室 (ICU).
主要成果:
- LTAC每年增长8.8%,在1997年至2006年期间,招生人数从13,732人增加到40,353人.
- 相关成本从4.84亿美元升至13.25亿美元;人口中LTAC使用率增加了一倍以上.
- 转移的患者表现出增加的并发病症和机械通风使用,高的一年死亡率 (超过50%).
结论:
- 严重疾病后的LTAC使用量很大,在医疗保险受益者中越来越多.
- 危急疾病后转移到LTAC的患者的生存结果很差,这表明需要进一步调查和潜在干预措施.
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