在家对待急性后护理的偏好与设施的偏好
Fangli Geng1,2,3, Brian E McGarry4, Meredith B Rosenthal5
1Harvard University Graduate School of Arts and Sciences, Boston, Massachusetts.
JAMA health forum
|April 26, 2024
概括
患者和护理人员更喜欢在家进行后急性护理,但社会经济因素和护理人员负担可能会改变偏好. 质量至关重要,对低于平均水平的熟练护理设施 (SNF) 护理有强烈的厌恶.
科学领域:
- 医疗保健经济学 医疗保健经济学
- 患者的偏好 患者的偏好
- 后急性护理交付 后急性护理交付
背景情况:
- 美国五分之二的住院需要急性治疗后的康复护理,通常在熟练护理机构 (SNF) 或家庭卫生机构 (HHA) 中进行.
- 目前的护理模式面临挑战,原因是指导方针不清楚,缺乏了解患者和护理人员的偏好.
- 促进高价值,以患者为中心的急症后护理需要对这些偏好有更深入的了解.
研究的目的:
- 评估患者和护理人员对医疗机构和家庭医疗机构的偏好.
- 为了评估不同后急症护理设置和属性的支付意愿.
- 检查人口变化如何影响这些偏好.
主要方法:
- 2022年9月,在45岁及以上的参与者中进行了一项全国代表性调查.
- 用一个离散选择实验来了解在机构和家庭护理选项之间的选择.
- 调查权重被应用,以确保对偏好和支付意愿的全国代表性估计.
主要成果:
- 患者和护理人员显著愿意为高质量,在家进行后急性护理 (例如,家庭卫生机构) 支付费用.
- 然而,随着护理人员需求的增加和社会经济挑战,如就业不安全,偏好转向基于设施的护理 (例如,SNF).
- 观察到对低于平均质量的护理的强烈厌恶,并愿意支付大量费用以避免这种情况.
结论:
- 人们普遍倾向于在家进行急性后护理,这与当前的政策方向保持一致.
- 面临护理人员限制和社会经济困难的弱势群体在转向家庭护理时可能会被忽视.
- 对以患者为中心的急性病后护理,特别是对边缘化群体来说,公平的支持和提高质量的措施至关重要.
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