共享护理网络协会与30天的心力衰竭过度医院再入院:纵向观察性研究
Diego Pinheiro1, Ryan Hartman2, Jing Mai3
1Unicap-Icam International School, Universidade Católica de Pernambuco, Recife, Brazil.
JMIRx med
|September 19, 2023
概括
更高的心力衰竭再入院率与共享护理网络有关. 这项研究表明,改善护理协调可能会减少再入院. 未来的计划应该考虑共享护理模式,以更好地管理心力衰竭.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 心脏病学 心脏病学
- 公共卫生 公共卫生
背景情况:
- 高心力衰竭 (HF) 再入院率对美国医院来说是一个持续的挑战,影响了护理质量和成本.
- 像医院再接收减少计划这样的现有计划显示出混合的结果和意想不到的后果.
- 分享护理网络在HF再接收中的作用仍未得到充分研究.
研究的目的:
- 调查共享护理网络与30天过度心力衰竭再入院率之间的关联.
- 分析共享护理区域内患者出院模式与医院再接收绩效的关系.
主要方法:
- 一项使用加利福尼亚州医院出院数据 (2012-2017年) 的纵向观察研究.
- 基于患者出院网络的共享护理区域的划定.
- 计算局部化指数,以测量患者在其入院区域内居住的情况.
- 使用概括估计方程进行统计分析,以评估本地化指数和高频回收率之间的关系,控制人口统计.
主要成果:
- 分析包括300家加利福尼亚医院在6年内.
- 更高的局部化指数 (更多的患者居住在他们的入院区域) 与较低的过度心力衰竭再入院率 (β=-.0474) 有意义地相关.
- 在共享护理区的黑人居民比例是唯一显著的共同变量,与再接收率积极相关 (β=.4128).
结论:
- 共享护理网络与心力衰竭再入院率有关.
- 这些发现表明,有组织的共享护理模式可能会影响HF再接收结果.
- 政策干预,如医院再接收减少计划,应考虑整合和奖励有效的共享护理策略,以优化HF患者管理.
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