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测量糖尿病护理的连续性:包括哪些访问?
Kevin R Riggs1, Caroline A Presley, April A Agne
1University of Alabama at Birmingham, 1720 2nd Ave S, MT 610, Birmingham, AL 35294-4410.
护理持续性的价值取决于所包含的提供者专业. 更狭窄的定义显示出更高的连续性,但与急诊室访问的关联较弱,这表明对医疗保健质量指标的影响有限.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 评估护理质量的评估.
- 医疗保健管理的管理
背景情况:
- 护理的连续性是一个关键的医疗保健质量指标.
- 现有的研究使用了包括医疗服务提供者访问的各种定义.
- 供应商专业选择对连续性措施的影响尚不清楚.
研究的目的:
- 评估不同的提供者专业分组如何影响护理价值的连续性.
- 评估连续性措施的年比年稳定性.
- 为了确定护理连续性和急诊室 (ED) 访问之间的关联.
主要方法:
- 阿拉巴马州医疗补助行政数据 (2018-2019) 的回顾性分析.
- 包括患有糖尿病的受益者 (N=9578) 每年至少进行3次门诊.
- 使用三个提供者分组计算了护理连续性指数 (COCI):所有提供者,糖尿病广泛和糖尿病狭窄.
主要成果:
- 平均COCI为0.54 (所有提供者),0.64 (糖尿病广泛) 和0.83 (糖尿病狭窄).
- 连续性测量显示年对年相关性中等 (斯皮尔曼 ρ,0.41-0.47).
- 所有的连续性测量都显示了与ED访问的弱相关性 (OR,0.99每0.1单位的COCI差异).
结论:
- 护理价值的连续性受到提供者专业的选择的重大影响.
- 较窄的供应商分组会产生更高的连续性得分,但不一定会提高ED访问的预测能力.
- 连续性测量变化的临床意义可能是有限的,因为与ED利用的联系很弱.
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