慢性阻塞性肺部疾病的老年人肺部康复利用,2013-2019年
Surya P Bhatt1, Jordan Westra2, Yong-Fang Kuo2
1Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and.
Annals of the American Thoracic Society
|January 19, 2024
概括
在患有慢性阻塞性肺病 (COPD) 的医疗保险受益人中,肺康复 (PR) 的使用率仍然很低,在2013年至2019年期间仅略有增加,从2.5%增加到4.0%. 年龄较小和专业护理等因素与PR使用率较高有关.
科学领域:
- 肺部病理学 肺部病理学
- 获得医疗保健 获得医疗保健 获得医疗保健
- 公共卫生 公共卫生
背景情况:
- 肺部康复 (PR) 显著改善慢性阻塞性肺病 (COPD) 患者的结果,包括运动耐受性,功能能力,呼吸障碍和生活质量.
- 尽管其已被证明有好处,但COPD患者对公关服务的访问和使用仍然不够理想.
- 了解影响公关使用的趋势和因素对于改善患者护理和结果至关重要.
研究的目的:
- 检查诊断为慢性阻塞性肺病 (COPD) 的成年人使用肺康复 (PR) 的趋势.
- 确定与大量COPD患者中使用PR相关的人口,临床和社会经济因素.
- 评估医疗保险受益人群中在一定的时间内PR利用率的变化.
主要方法:
- 从2013年到2019年,对20%的医疗保险受益人群进行了回顾性分析.
- 根据门诊访问或住院住院的诊断代码识别COPD的成年人.
- 使用现行程序术语和医疗保健共同程序编码系统代码来确定PR利用率;用于识别相关因素的后勤回归模型.
主要成果:
- 观察到PR利用率略有增加,从2013年的2.5%上升到2019年的4.0%,表明总体使用率持续低.
- 与较高的PR使用相关的因素包括年龄较小 (66-74岁),白人,社会经济地位较高,并发症得分较低,城市居住和肺病学家的护理.
- 大多数患有COPD的医疗保险受益者在研究期间没有参加PR计划.
结论:
- 在患有COPD的医疗保险受益者中,利用肺康复 (PR) 的比例变化很小,并且仍然很低.
- 可能需要有针对性的干预措施来改善这种患者群体的PR访问和吸收.
- 进一步的研究应该探索PR访问的障碍和增加其利用的策略.
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