国家急诊室使用费用服务医疗保险受益者与痴呆症的模式
Jason K Bowman1,2,3, Christine S Ritchie3,4, Kei Ouchi1,3
1Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Journal of the American Geriatrics Society
|June 5, 2024
概括
患有阿尔茨海默氏症和相关痴呆症 (ADRD) 的人经常使用急诊室 (ED),特别是在住院或住院后. 需要有针对性的干预措施来减少可避免的急救诊所访问,并将护理与患者的目标协调一致.
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
- 公共卫生 公共卫生
背景情况:
- 阿尔茨海默氏症和相关痴呆症 (ADRD) 患者承担高昂的急性护理费用,其益处不确定.
- 紧急诊所 (ED) 访问是ADRD患者的关键决策点.
- 了解ADRD中ED使用模式对于医疗保健规划至关重要.
研究的目的:
- 分析患有阿尔茨海默病和相关痴呆症 (ADRD) 的医疗保险受益人中急诊室 (ED) 的使用情况.
- 在ADRD人群中确定与高ED利用率相关的因素.
- 为减少可避免的急性护理事件提供有针对性的干预信息.
主要方法:
- 对66岁以上的传统医疗保险注册者进行回顾性队列研究,诊断为痴呆症.
- 分析一年的结果,包括急救访问 (有/没有住院),每100天的急救访问,以及医疗保健费用.
- 多变量回归建模,以评估护理地点和随后的ED利用之间的关联.
主要成果:
- 在2018年,超过260万ADRD患者进行了超过320万次ED访问.
- 超过一半的ADRD患者至少有一次ED访问;15.5%有三次或更多.
- 最近从医院出院的患者,熟练护理机构 (SNFs) 或接受家庭医疗保健的患者的ED利用率最高.
结论:
- 患有ADRD的患者,特别是最近住院的患者,使用ED的比例很高.
- 在ED遭遇期间或之前的干预措施可能会减少可避免的利用率.
- 确保符合目标的护理对于获得急性护理服务的ADRD患者至关重要.
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