从州内医院出院数据中估计特定州的基于人口的住院率
Marc Roemer1, Mary Beth Schaefer2, Gary T Pickens3
1Agency for Healthcare Research and Quality, Rockville, Maryland, USA.
Health services research
|August 21, 2023
概括
研究人员开发了权重来准确估计州住院率,仅使用州内数据. 这些权重有助于解释在本州以外接受治疗的患者,改善基于人口的健康指标.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 生物统计学 生物统计学
- 公共卫生 公共卫生
背景情况:
- 估计特定州的住院率对于公共卫生监测至关重要.
- 州内医院数据往往不包括在州外接受治疗的居民,导致潜在的低估.
- 基于人口的准确率需要考虑医疗保健服务的患者迁移.
研究的目的:
- 开发和验证统计权重,以估计基于州人口的住院率.
- 为应对州外住院居民数据缺失的挑战.
- 为研究人员提供使用单个州医院出院数据的方法.
主要方法:
- 利用了来自47个州和华盛顿特区 (2018-2019) 的医疗保健成本和利用计划 (HCUP) 国家住院患者数据库 (SID).
- 使用2018年的数据,确定和描述了"搬家者" (在州外住院) 与"住院者" (在州内住院) 的情况.
- 根据搬家/停留者的特征制定了权重,并根据2019年的观察数据对验证的估计进行了验证.
主要成果:
- 在2018年,4.2%的出院患者是"移动者".
- 总排放量的基于重量的估计显示,与观察到的2019年数据相比,平均绝对百分比误差低 (0.2%).
- 对于特定的子组 (包括付款人,收入水平和诊断) 发现了差异,估计值通常在95%的置信区间之外.
结论:
- 开发的权重提供了一个实用的方法,在使用单个州数据时调整州外住院.
- 这种方法提高了基于人口的住院率计算的准确性.
- 研究人员可以利用这些权重来改善健康结果分析,而数据访问有限.
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