在心力衰竭的医疗保险受益人中提前护理计划 (ACP)
Seuli Bose Brill1,2, Sean R Riley3,4,5, Laura Prater5
1Division of General Internal Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, 2050 Kenny Road, Columbus, OH, 43215, USA. Seuli.Brill@osumc.edu.
Journal of general internal medicine
|May 20, 2024
概括
预先为心力衰竭患者进行护理规划是罕见的,但可能会降低生命末期医疗保健成本. 这项研究发现,随着事先的护理规划,总支出和住院患者使用率较低,门诊服务利用率增加.
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:
- 心力衰竭是美国的主要死亡原因,与高终身医疗保健支出有关.
- 有限的证据表明,预计预先护理计划 (ACP) 对心力衰竭患者的医疗保健利用的影响有限.
- 需要进行大规模的索赔数据分析,以告知有关心力衰竭中ACP的政策和临床实践.
研究的目的:
- 评估心力衰竭的医疗保险受益者在生命的最后30天内预计预先护理计划 (ACP) 和医疗保健利用之间的关联.
- 确定ACP对所使用的终身医疗保健服务的类型和数量的影响.
主要方法:
- 从2016年到2020年使用Medicare服务费索赔的回顾性横截面队列研究.
- 包括48,466名被诊断为心力衰竭的已故患者.
- 检查了过去12个月和30天生命中的ACP账单服务作为暴露,测量住院,门诊,宿舍,熟练护理设施和家庭医疗保健服务的终身利用率和总支出.
主要成果:
- 在48,466名患者中,有4,406名患者 (9.1%) 遇到了预先护理计划.
- 与未收费的患者相比,已收费的非洲及非洲国家接触的患者的生命终端总支出比未收费患者低19%.
- 收费ACP患者的终身门诊利用率 (2.65倍) 和门诊支出增加 (33%高) 的几率更高.
结论:
- 在心力衰竭患者中,预先预约的护理计划发行不常见.
- 优先考虑心力衰竭患者的ACP可能会降低总体生命终端和住院费用.
- 通过促进门诊终生服务的使用,包括家庭医疗保健和临终关怀,ACP可以降低成本.
相关概念视频
01:21Planning Nursing Care I
4.4K
The planning phase of the nursing process helps nurses set priorities, outline patient-centered goals and expected outcomes, and tailor nursing interventions to align with the aligned care plan. Through the planning phase, the nurse applies critical thinking skills to align and develop interventions according to the patient's needs. It provides continuity of care allowing patients to receive the maximum benefit from treatment. It serves as a pilot plan for allocating individual staff to a...
4.4K
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
421
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
421
01:19Standards of Care II
641
Nurses bear specific legal responsibilities under several federal statutes, including:
641
01:29Planning Nursing Care II
2.6K
A nursing care plan can present in two forms: informal and formal. Informal is a care plan for the individual use of the nurse and goals they wish to accomplish during their shift. Informal care plans are not included in the patient chart. A formal nursing care plan is a written or computerized guide that organizes patient care. It is further subdivided into two: standardized and individualized care plans. Standardized care plans are pre-populated care plans for specific patient populations,...
2.6K
01:29Documentation in Long-Term and Home Healthcare Setting
882
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
882
01:17Pathophysiology of Heart Failure
1.6K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.6K