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定义美国医院儿科能力的水平
Kenneth A Michelson1, Elizabeth R Alpern1, Katherine E Remick2
1Division of Emergency Medicine, Ann & Robert Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
一个新的4级系统对儿科医院的能力进行了分类,有助于了解护理准入和结果. 这种分类有助于在全国范围内跟踪儿科急性护理的质量.
科学领域:
- 儿科医疗保健系统 儿科卫生保健系统
- 医疗服务研究 医疗服务研究
- 医院质量指标 医院质量指标
背景情况:
- 了解各医院儿科护理能力的差异对于改善患者的治疗结果和获得专业服务至关重要.
- 现有的分类系统可能无法充分捕捉急症医院提供的儿科服务的范围.
研究的目的:
- 开发和验证一个强大的分类系统,根据其儿科能力对医院进行分类.
- 创建一个标准化的方法来评估医院提供的医疗,外科和专业儿科服务的范围.
主要方法:
- 一项横截面研究利用了美国10个治疗儿童的州急症医院的2019年数据.
- 通过隐性类别分析,根据26个功能能力定义了4个不同的儿科医院能力水平.
- 该分类系统使用来自三个额外状态的数据进行了外部验证.
主要成果:
- 隐性类分析确定了4个儿科医院级别,在功能能力,住院病床,儿科重症监护室 (PICU) 病床和转诊率方面有明显的区别.
- 一级医院表现出最高的能力 (中位数为24/26服务,66张住院病床,19张PICU病床,1%的转诊率).
- 相反,4级医院的能力最少 (中位数为3/26个服务,0个床位,100%的转诊率),这表明儿科护理提供有限.
结论:
- 一个新的4级分类系统有效地根据儿童医疗能力对医院进行分类.
- 该系统与关键的结构 (床位,PICU) 和利用 (转诊率) 特性相关,为护理提供提供了洞察力.
- 开发的分类系统为监测和改进国家儿科急性护理准入和结果提供了有价值的工具.
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