阿巴拉契山脉的养老院:质量,人员和成本的描述性分析
Andrew M Wong1, Robert Tyler Braun2
1Yale University, New Haven, CT, USA.
Journal of the American Medical Directors Association
|July 31, 2024
概括
阿巴拉契亚州的养老院在护理质量和人员配置方面与非阿巴拉契亚地区相比存在差异. 政策制定者必须解决这些差异,以改善阿巴拉契亚地区的老年人护理.
科学领域:
- 老年学和卫生服务研究研究
- 农村健康差异 农村健康差异
- 医疗保健质量和政策
背景情况:
- 阿巴拉契山脉的养老院往往为不同的人群提供服务,并面临独特的运营挑战.
- 之前的研究还没有全面比较阿巴拉契亚和非阿巴拉契亚养老院在不同地理环境中的护理质量.
- 了解养老院质量的区域差异对于公平的医疗保健服务至关重要.
研究的目的:
- 调查美国阿巴拉契亚和非阿巴拉契亚地区的养老院在护理质量,人员数量和成本方面的差异.
- 将位于大都市,小城市和农村地区的阿巴拉契亚养老院与非阿巴拉契亚养老院进行比较.
- 确定护理质量和资源分配可能存在差异的特定领域.
主要方法:
- 医疗保险费用报告和养老院的回顾性分析 对14040个养老院的数据 (2013-2019年) 进行比较.
- 使用农村-城市通勤区代码对养老院进行分类,以定义阿巴拉契亚山脉和非阿巴拉契亚山脉设置.
- 进行比较描述性分析和回归模型,检查健康缺陷得分,医疗保险支出,人员工作时间 (RN,LPN,CNA) 和最低数据集指标.
主要成果:
- 阿巴拉契山脉的养老院更有可能是医院,营利性,并与连锁公司关联,白人和医疗补助居民比例更高.
- 阿巴拉契亚大都市家庭的认证护理助理工作时间较低,健康缺陷得分较高,医疗保险支出较高.
- 阿巴拉契山脉的农村家庭显示出更多的注册护士小时,但医疗保险支出也更高,缺陷评分的结果各不相同.
结论:
- 在阿巴拉契亚州,与非阿巴拉契亚地区相比,养老院人员和医疗保险支出在每位受益者之间存在显著的差异.
- 决策者在制定支持阿巴拉契亚地区老年人的举措时需要考虑这些区域不平等.
- 有针对性的干预措施可能是必要的,以应对阿巴拉契亚养老院及其居民面临的独特挑战.
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