临终关怀的编码和数据公约有助于过度简化临终关怀中痴呆的存在
Julia Driessen1, Sonal Parasrampuria1, Elvedin Bijelic1
1Center for Medicare & Medicaid Innovation, Centers for Medicare & Medicaid Services, Baltimore, MD, USA.
概括
痴呆症诊断往往没有在临终关怀索赔中列为主要诊断,30%的诊断完全缺失. 这种低估影响了人们对在宿舍环境中使用痴呆症护理的理解.
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
- 医疗信息学 医疗信息学
背景情况:
- 痴呆症是宿舍患者中普遍存在的疾病.
- 当前的临终关怀文献往往侧重于初级诊断,可能低估了痴呆症的影响.
- 对于患有痴呆症的宿舍患者作为次要或未列出的诊断的医疗保健利用情况知之甚少.
研究的目的:
- 检查痴呆症诊断在临终关怀索赔中是如何表示的.
- 调查痴呆症诊断表现和住院利用模式之间的关系.
主要方法:
- 医疗保险索赔数据的二次分析.
- 包括在2016-2018年期间至少两次痴呆症诊断的医疗保险受益人,他们在2018年选择住院.
- 根据痴呆症诊断的存在和临终关怀索赔的位置,受益人被分为三组:初级,二级或不存在.
主要成果:
- 只有不到一半的痴呆症受益者将其列为主要的临终关怀诊断.
- 大约30%的被诊断为痴呆症的受益人没有在他们的临终关怀索赔中出现这种情况.
- 在三个诊断呈现组中,观察到住宿时间和利用率的显著差异.
结论:
- 宿舍索赔编码和测序实践可能导致低估和过度简化痴呆症的存在和影响.
- 目前的研究方法可能无法完全捕捉住宿舍护理中痴呆症的范围.
- 需要进一步完善诊断编码和研究方法,以准确评估住院痴呆症护理.
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