美国医院的COVID-19入院率和护理质量的变化
Giacomo Meille1, Pamela L Owens1, Sandra L Decker1
1Agency for Healthcare Research and Quality, US Department of Health and Human Services, Rockville, Maryland.
对于非COVID-19患者的医院护理质量在COVID-19激增期间下降. 高的COVID-19入院率与压力和死亡率等不良结果的增加有关,强调需要在高峰医院需求期间保持护理标准的策略.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 提高质量 提高质量
- 流行病学 流行病学
背景情况:
- 2020年COVID-19大流行导致医院占用率达到前所未有的水平.
- 在这些激增期间,人们对非COVID-19患者的护理质量产生了担忧.
- 了解COVID-19入院对一般医院护理质量的影响至关重要.
研究的目的:
- 对没有COVID-19的患者的医院非手术护理质量的变化进行检查.
- 在COVID-19住院人数较高和较低的时期比较护理质量.
主要方法:
- 采用来自36个州的2019-2020年医疗保健成本和利用项目的数据进行横截面研究.
- 包括非COVID-19,非肺炎患者在选择的质量指标的风险.
- 根据每100张床的COVID-19入院人数对医院周进行分类;分析了不良结果和死亡率.
主要成果:
- 分析包括来自3,283家医院的1900多万次出院.
- 在高COVID-19入院周 (每100张床≥15张) 中,与低入院周 (每100张床<1张) 相比,质量指标明显恶化.
- 观察到压力发病率 (24.3%),心力衰竭死亡率 (21.1%),骨折死亡率 (29.4%) 的增加.
结论:
- COVID-19的急剧增长与非COVID-19患者医院护理质量的显著下降有关.
- 增加的不良结果凸显了在需求高峰期对医疗保健系统的压力.
- 需要制定策略,在医院利用率高的时期保持高质量的护理.
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