在密集护理和中间护理的机械通风患者中农村和城市死亡率的差异
Emily A Harlan1,2,3,4, Shrathinth Venkatesh1, Jean Morrison5
1Division of Pulmonary and Critical Care, Department of Medicine.
Annals of the American Thoracic Society
|January 31, 2024
概括
与城市环境相比,农村中等护理单位的住院治疗与较高的死亡率有关. 需要进一步的研究来了解患者选择和使用这些逐步降低的护理单位.
科学领域:
- 医疗保健管理的管理
- 关键护理医学 关键护理医学
- 农村卫生 农村卫生
背景情况:
- 介护病房为特定患者提供了低成本的重症监护替代方案.
- 农村医院可以利用中间护理单位来实现财务可持续性.
- 对中级护理的结果数据有限,特别是在农村环境中.
研究的目的:
- 调查医院位置 (农村与城市) 与患者死亡率之间的关系.
- 分析不同护理环境 (重症监护,中等监护,一般监护) 中机械通风患者的死亡率.
- 评估农村环境对中等护理单位患者治疗结果的影响.
主要方法:
- 对从2010年到2019年接受侵入性机械通风的医疗保险受益者 (65岁以上) 的分析.
- 多变量后勤回归用于比较农村和城市医院之间的30天死亡率.
- 模型根据患者的人口统计,诊断,并发症,疾病严重程度和医院特征进行调整.
主要成果:
- 分析了超过270万例住院病例;7.0%发生在农村医院.
- 在2010年至2019年期间,农村中级护理中的患者比例从4.1%增加到6.3%.
- 调整后的30天死亡率在农村和城市重症监护病房 (46.7%) 中是相似的,但在农村中介护理 (36.9%) 和城市中介护理 (31.3%) 中明显高.
结论:
- 在农村中介护理单位住院治疗与患者死亡率的增加有关.
- 迫切需要更好地了解中介护理单位的利用和患者选择标准.
- 仔细评估患者适合中级护理的情况至关重要,特别是在农村环境中.
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