医疗保险受益者在辅助生活社区中的家庭时间和州法规
Yunjiao Mao1, Yue Li1, Brian McGarry1,2
1Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Journal of the American Geriatrics Society
|December 8, 2023
概括
辅助生活居民在家里度过了94%的时间,但这取决于居民的需求和州法规. 直接照顾工作者 (DCW) 的具体培训和人员规则与更多的家庭时间有关.
科学领域:
- 老年学是一门学科.
- 医疗保健服务研究 医疗服务研究
- 生活质量指标 生活质量指标
背景情况:
- 家庭时间是辅助生活 (AL) 居民的关键以患者为中心的质量指标,但它仍未得到充分研究.
- 了解影响家庭时间的因素对于改善AL环境中的居民福祉至关重要.
研究的目的:
- 在入院后的一年内,分析AL居民在家时间的变化.
- 调查国家法规 (直接护理工作者培训/人员配置,执照护士人员配置) 和AL居民在家的时间之间的关系.
主要方法:
- 分析了2018年入院AL的59,831名医疗保险受益人的队列.
- 家庭时间的计算是每天在家度过的时间的百分比.
- 多变量回归模型,包括AL级固定效应,检查居民特征和国家法规对家庭时间的影响.
主要成果:
- 在入院后的一年里,AL居民平均在家里度过了94%的时间.
- 与减少家庭时间相关的因素包括医疗保险和医疗补助的双重资格和多种/特定的慢性疾病 (例如痴呆症).
- 对于直接护理工作者 (DCW) 培训和人员配置有更具体的规定,而对于执照人员配置则不那么具体的州,居民在家的时间更长.
结论:
- 在AL的家庭时间根据居民的个人资料和州监管方法有很大差异.
- 医疗保险和医疗补助双重资格的居民在家的时间减少了,通常是由于养老院停留时间增加.
- 州对DCW和执照工作人员的规定影响AL居民的家庭时间,为政策和运营改进提供了见解.
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