服务于辅助生活居民的宿舍提供者:较高数量与较低质量的关联
Wenhan Guo1, Helena Temkin-Greener1, Brian E McGarry2
1Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Journal of the American Geriatrics Society
|March 28, 2024
概括
有更多辅助生活 (AL) 患者的临终关怀提供者报告了更低质量的护理. 护理人员注意到疼痛管理,情绪支持和沟通方面的问题. 需要进一步的研究来提高AL居民的护理质量.
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
- 抚慰性护理是一种缓解性护理.
背景情况:
- 辅助生活 (AL) 社区护理人员经常报告临终关怀护理质量不佳.
- 对于服务于AL居民的宿舍提供者以及影响质量差异的因素的了解有限.
- 这项研究调查了临终关怀医院提供者AL患者数量及其质量评级之间的联系.
研究的目的:
- 检查临终关怀医院提供者每天的AL患者数量和质量评级之间的关联.
- 确定导致AL居民宿舍护理质量差异的因素.
- 在AL临终关怀市场中提供有针对性的质量改进计划的信息.
主要方法:
- 使用Medicare比较数据和索赔的横截面研究.
- 确定了符合Medicare资格的AL居民,并将他们与临终关怀索赔联系起来.
- 采用线性概率模型来评估AL数量与质量指标 (HIS,CAHPS) 之间的关系,控制提供商特征.
主要成果:
- 高AL体积的临终关怀医院提供者在疼痛评估,呼吸障碍治疗和情绪支持方面出现较低护理人员评级的可能性增加.
- 护理人员报告说,与AL数量较高的提供者进行的沟通较差,家庭培训效果较差.
- 这些提供者在CAHPS调查和HIS综合测量中不太可能获得高的总分.
结论:
- 管理更高数量的AL患者日的临终关怀提供者往往表现出较低的质量得分.
- 进一步的研究是必要的,以阐明在AL市场中低质量的供应商集中的原因.
- 确定这些原因将使得制定有针对性的策略,以提高AL居民的宿舍护理质量.
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