通过在熟练的护理机构标准化慢性病的管理来预防可避免的再住院
Ya Luan Hsiao1, Eric B Bass2, Albert W Wu2
1Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Journal of the American Medical Directors Association
|September 10, 2023
概括
标准化护理协议减少了慢性阻塞性肺病 (COPD) 患者的再入院,这些患者被送往熟练护理机构 (SNF). 充血性心力衰竭 (CHF) 协议影响不太一致,突出了护理协调的价值.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 减少患者再入院的策略
- 慢性疾病管理 慢性疾病管理
背景情况:
- 由于充血性心力衰竭 (CHF) 和慢性阻塞性肺病 (COPD) 的重入院是医疗保健的重大负担.
- 有效的出院规划和护理协调对于管理过渡到熟练护理设施 (SNFs) 的医疗复杂患者至关重要.
研究的目的:
- 评估通过J10ohns霍普金斯社区卫生伙伴关系 (J-CHiP) 倡议实施的标准化护理协议对30天医院再入院率的影响.
- 评估这些方案对患者的有效性CHF和/或COPD释放到SNFs.
主要方法:
- 一个回顾性研究设计,比较在实施标准化护理协议之前和之后的再入院率.
- 分析了从约翰霍普金斯医院出院到参与的SNF诊断为CHF和/或COPD的患者的数据.
- 标准化协议包括SNF入院评估,多学科护理规划和药物管理.
主要成果:
- 对于患有COPD协议的患者,重收率显著降低 (2011年为23.5%,2015年为12.1%).
- 开始CHF协议的患者的再入院率呈现波动,并且改善不那么稳定.
- 这项研究包括前J-CHiP队列中的1128名患者和J-CHiP队列中的2297名患者.
结论:
- 标准化护理方案显示出减少再入院的希望,特别是在转换到SNF的COPD患者中.
- 加强医疗保健系统和慢性护理机构之间的合作对于管理复杂的患者过渡至关重要.
- 进一步的研究应该探索影响可预防的医院再入院的非临床因素.
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