家庭优先还是医院优先? 一个倾向性评分权重的回顾性队列研究
Stephanie Q Ko1, Guang Cheng2, Tze Yeong Teng3
1NUHS@Home, National University Health System, Singapore, Singapore; Division of Advanced Internal Medicine, Department of Medicine, National University Hospital, Singapore, Singapore.
Journal of the American Medical Directors Association
|July 17, 2024
概括
直接接收符合条件的COVID-19患者到医院在家 (HaH) 护理是安全有效的. 这种方法可以减少住院时间,而不会影响临床结果,提供更有效的护理模式.
科学领域:
- 提供医疗保健的模式.
- 传染病管理 传染病管理
- 患者结局研究研究结果.
背景情况:
- 在家医院 (HaH) 计划提供了传统住院护理的替代方案.
- 在HAH计划中比较不同的入学途径对于优化护理提供至关重要.
研究的目的:
- 在医院在家计划中,比较家庭第一和医院第一入院模型之间的临床和利用结果.
- 评估COVID-19患者直接入院到HaH的安全性和效率.
主要方法:
- 在新加坡HaH计划中对1025名COVID-19患者进行了回顾性队列研究.
- 主要结局:氧化,ICU入院和全因死亡率的组合.
- 利用结果:停留时间;用于调整的倾向性得分权重和回归分析.
主要成果:
- 在家庭第一和医院第一组之间,初级复合临床结果没有显著差异 (OR,1.17;95% CI,0.44-3.10).
- 首先在家的患者平均逗留时间缩短了2.02天 (95% CI,1.10-2.93).
- 两组之间没有观察到临床结果的统计学上显著差异.
结论:
- 适合医疗护理的COVID-19患者可以在没有先前住院治疗的情况下直接入院.
- 家庭优先模式证明了可比的临床安全性,提高了效率 (停留时间更短).
- 应考虑对符合条件的患者进行直接入院,以优化资源利用和患者流动.
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