家庭托儿所和息护理提供者访问:对医疗保健利用的影响
Steven M Smith1, Daniel H Grossoehme2, Kate Cicozi1
1Department of Anesthesia Section of Palliative Care and Hospice, Nationwide Children's Hospital, Columbus, OH.
The Journal of pediatrics
|February 3, 2024
概括
家庭临终关怀和息护理 (HBHPC) 提供者家庭访问减少了儿科患者住院和重症监护室的入院时间. 这些访问也增加了患者与医疗服务提供者的沟通,提高了护理的可获得性.
科学领域:
- 儿科医疗保健 儿科医疗保健
- 抚慰性护理是一种缓解性护理.
- 医疗保健利用情况 医疗保健利用情况
背景情况:
- 家庭托管和息护理 (HBHPC) 服务旨在改善患有严重疾病的患者的生活质量.
- 提供HBHPC家庭访问 (HV) 对儿科人口医疗利用的影响仍然是需要进一步调查的领域.
研究的目的:
- 评估HBHPC提供者家庭访问对儿童和年轻成年人医疗保健利用的影响.
- 为了确定HBHPCHV是否与住院入院,住院日数和重症监护室 (ICU) 日数的变化有关.
主要方法:
- 在2013年至2018年期间接受HBHPC提供者HV的195名儿科患者 (1个月至21岁) 的回顾性评估.
- 医疗保健利用指标的比较 (ICU日,住院住院,住院日,电话) 在最初的HBHPC提供者HV之前和之后的一年.
- 使用配对t测试或Wilcoxon签名等级测试进行统计分析,以比较HV前后的数据.
主要成果:
- 提供HBHPC的HV与ICU日数 (中位数为12至0),住院入院 (中位数为1至1) 和住院日数 (中位数为5至2) 的显著减少有关.
- 临床上与HBHPC团队相关的电话数量显著增加 (中位数为1至4),以及急诊室访问之前的电话数量 (中位数为0至1).
- 患者的诊断包括神经 (49%),先天性染色体 (30%),瘤 (11%),心脏 (7%).
结论:
- 提供HBHPC的HV与儿科病人的住院医疗利用率下降有关.
- 通过电话通话增加的沟通表明,HBHPC HV增强了患者的参与度,并可能转移不必要的急诊.
- 这些发现支持HBHPC HVs在优化护理提供和减少儿科患者医疗资源负担方面的作用.
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