需要证书政策与宿舍质量结果之间的关联
Arlen G Gaines1, John G Cagle2
1Doctoral Program in Palliative Care, Department of Pharmacy Practice and Science, University of Maryland, Baltimore, MD, USA.
The American journal of hospice & palliative care
|May 31, 2023
概括
需要证书 (CON) 法律似乎适度地改善了宿舍的质量结果. 与非CON州的医院相比,CON州的医院在关键质量指标上表现更好.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健政策和法规 医疗保健政策和法规
- 改善息治疗的质量改善
背景情况:
- 需要证书 (CON) 法律是特定州的法规,要求对新的医疗保健设施和资本投资进行监管批准.
- 这些法律影响了14个州和哥伦比亚特区的宿舍运营,在几个司法管辖区正在进行立法审查.
研究的目的:
- 调查需要证书 (CON) 状态和宿舍质量结果之间的关联.
- 利用临终关怀项目集 (HIS) 度量来评估不同监管环境中的质量表现.
主要方法:
- 使用2022年2月的医疗保险住院提供者和一般信息报告,对来自4,870家美国住院的数据进行横截面分析.
- 在CON和非CON状态的临床医院之间平均临床医院项目集 (HIS) 措施的比较.
- 多重回归分析以根据CON状态预测HIS结果,控制宿舍所有权和规模.
主要成果:
- 大多数临终关怀 (86%) 在没有临终关怀的CON规定的国家运营.
- 与非CON州的医院相比,CON州的医院在大多数质量指标中显示出更高的未调整的平均HIS分数.
- 经过调整后的分析显示,在CON状态下,对于所涉及的信念和价值观,疼痛评估,呼吸障碍治疗和综合质量衡量,HIS评级显著更高.
结论:
- 需要证书 (CON) 规定可能对住院报告的质量结果产生积极的影响,尽管很小.
- 对于中小医院来说,CON法律的有益影响似乎更为明显.
- 建议进行进一步的研究,以确定影响宿舍质量指标的其他因素.
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