养老院的特殊护理单位对医疗保健利用率和成本的影响:一种使用倾向性得分匹配的病例对照研究
Eunhee Cho1, Eun-Young Kim2, Kyung Hee Lee1
1Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea.
International journal of nursing studies
|September 23, 2023
概括
韩国养老院的特殊护理单位模式,由注册护士领导,大大降低了居民的医疗保健利用率和成本. 这种由护士主导的方法有望改善养老院护理质量和结果.
科学领域:
- 老年学和长期护理
- 医疗保健服务研究 医疗服务研究
- 护理实践和行政管理
背景情况:
- 韩国养老院面临着专业护理人员不足的挑战,导致不必要的医院转移.
- 一个试点项目,即养老院的特殊护理单位,通过确保注册护士的最低人数和定义其实践范围来解决这些服务差距.
研究的目的:
- 评估特殊护理单位模型对养老院居民医疗保健利用的影响.
- 评估这种由护士主导的模型对与养老院护理相关的整体医疗保健成本的影响.
主要方法:
- 一项使用倾向性得分匹配的比较有效性研究.
- 全国共有18个养老院参与了这项研究,有323对住户在案例 (特殊护理单位) 和对照组中匹配.
- 用通用估计方程分析六个月的医疗保健利用率和成本差异.
主要成果:
- 两组之间没有观察到基线特征或死亡率的显著差异.
- 特殊护理单位组在医院住院频率,住院时间和相关费用方面显示出统计学上显著的减少.
- 门诊诊次数和费用,以及家庭医疗保健利用率和病例组的费用也显著下降.
结论:
- 通过特殊护理单位模式实施专业护理服务,有效降低了养老院的医疗保健利用率和成本.
- 护士领导的模型,包括强制注册护士人员和受保护的实践范围,为改善长期护理机构居民健康结果提供了一个有希望的策略.
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