在重大下肢截肢之后,护理碎片化的影响
Braedon R Urie1, Taylor Laskowski1, Michele Richard1
1Section of Vascular and Endovascular Surgery, Department of Cardio-Vascular and Thoracic Surgery, Rush University Medical College, Chicago, IL.
Annals of vascular surgery
|December 20, 2023
概括
护理的碎片化 (CF) 显著增加了重收率和医疗保健费用,为患者经历重大下肢截肢. 解决CF对于改善患者的治疗结果和减少整体医疗保健支出至关重要.
科学领域:
- 血管外科手术的结果
- 医疗保健管理的管理
- 患者再接收分析
背景情况:
- 护理碎片化 (CF) 是一个已知的不良外科结果的风险因素,包括再入院,发病率和死亡率.
- 对于因外周血管疾病 (PVD) 进行重大下肢截肢的患者,CF的影响需要进行具体评估.
研究的目的:
- 评估外周血管疾病患者的护理碎片化和截肢后结果之间的关联.
- 为了确定CF是否影响再入院率,死亡率,停留时间和主要下肢截肢后的医院费用.
主要方法:
- 利用了纽约 (2016) 和MD/FL (2016-2017) 的医疗保健成本和利用项目数据库.
- 使用ICD-10代码鉴定了因PVD而经历主要下肢截肢的患者.
- 在研究期间,CF被定义为在≥2个医院的入院,并将碎片化和非碎片化护理组之间的结果进行比较.
主要成果:
- 总共分析了2,742名患者的13,749次遭遇;59.2%的人患有CF.
- 患有CF的患者表现出更高的并发症指数和更高的入院费用指数.
- 结核病独立地与显著更高的30天和90天再入院率 (HR分别为1.65和1.66) 相关,但与死亡率无关.
结论:
- 护理的碎片化与重收率的增加,停留时间的延长,以及主要下肢截肢后的更高的医院费用有关.
- 护理提供者之间加强合作对于确保PVD患者的护理连续性至关重要,从而提高质量和降低成本.
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