通过美国医院特征探索COVID-19人口普查负担:农村和关键接入医院的质量报告的影响
Ugochukwu C Ugwuowo1, Sarah K Meier2, Pablo Moreno Franco3
1Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Jacksonville, Florida, USA.
概括
大多数美国医院的COVID-19医院病床占用率相似. 然而,关键接入医院面临更大的负担,这表明需要对这些设施的质量报告进行风险调整.
科学领域:
- 医疗保健管理的管理
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 评估COVID-19大流行对医院资源分配的影响对于了解医疗保健系统弹性至关重要.
- 传统上,医院质量基准测试依赖于根据患者和设施特征进行风险调整.
研究的目的:
- 检查COVID-19患者人口普查负担和各种医院特征之间的纵向关联.
- 为了确定疫情时代的医院质量基准测试是否需要针对特定的医院级因素进行风险调整或分层.
主要方法:
- 利用了美国卫生和人类服务部的数据 (2020年8月至2023年8月) 和美国医院协会调查数据.
- 根据占用床位的百分比计算每周COVID-19压力水平 (低,中等,高,极端).
- 根据15个医院的特点进行分层分析,包括临界接入状态,床位大小和农村地区.
主要成果:
- 美国2582家医院的平均每周COVID-19患者占用率为6.7%.
- 12%的住院周经历了极端的COVID-19压力 (占床位≥20%).
- 在大多数医院类型中,COVID-19的负担是相似的,但对于关键接入医院来说,负担显著更高.
结论:
- 美国大多数医院类型的总体COVID-19人口普查负担是可比的.
- 医院质量报告可能不需要针对流行病结果进行广泛的风险调整,但农村或关键接入医院除外.
- 临界接入医院经历了不成比例的高COVID-19负担,保证了特定的风险调整考虑.
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