在医疗保险受益人中,从护理机构进行碎片化再入院
Sara D Turbow1,2, Molly M Perkins3, Camille P Vaughan3,4
1Division of General Internal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
概括
与返回家园的患者相比,从护理机构出院的医疗保险患者面临着更高的碎片化再入院风险. 这种护理的碎片化增加了死亡率和随后的再入院,突出了干预的关键领域.
科学领域:
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
- 医疗保健的质量和安全
背景情况:
- 医疗保险受益者在护理机构出院后的再接收率很高.
- 在不同医院发生的碎片化再入院增加了患者的死亡率和未来的再入院风险.
- 了解导致再入院分散的因素对于改善护理过渡至关重要.
研究的目的:
- 调查从护理机构重新接收的医疗保险受益人是否比从家中重新接收的受益人更容易受到分散的再接收.
- 为了确定阿尔茨海默病 (AD) 的诊断是否会影响护理机构出院和碎片化再入院之间的关联.
主要方法:
- 对2018年医疗保险受益者队列的分析.
- 从护理机构出院的受益人与在家出院的受益人之间的碎片化再接收率的比较.
- 统计建模 (完全调整的模型) 来评估关联,控制潜在的混因素.
主要成果:
- 从护理机构重新接收的患者有19%的可能性更大 (AOR 1.19,95%CI 1.16,1.22).
- 这种从护理机构重新入院的碎片化可能性增加并没有受到阿尔茨海默病诊断的显著影响.
- 这些发现表明,护理机构出院和护理分散之间存在强有力的关联.
结论:
- 从护理机构出院是医疗保险受益人中分散的再入院的一个独立风险因素.
- 护理机构的再接收可能会导致老年人的护理分散,影响整体健康结果.
- 从护理机构对护理过渡的定位代表了碎片化再入院的潜在可修改的医院前风险因素.
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