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Vivek N Pandey¹, John W Moore¹, Sarah K Thomas¹

¹Department of Orthopaedics & Physical Medicine, Medical University of South Carolina, Charleston, SC, USA.

Journal of shoulder and elbow surgery

|October 11, 2024

概括

在全肩关节整形术 (TSA) 后,将患者送往急症后护理 (PAC) 设施,与在家出院相比,增加了再接收风险. 在基于价值的护理模型中,仔细考虑出院目的地对于优化患者的治疗结果和医疗保健成本至关重要.

科学领域:

整形外科手术整形外科手术
医疗保健服务研究医疗服务研究
以价值为基础的护理

背景情况:

全肩关节整形术 (TSA) 的使用正在增加,越来越关注以价值为基础的护理和成本效益.
了解TSA后再接收驱动因素对于管理医疗保健支出至关重要.
之前的研究指出,家庭医疗保健 (HHC) 或急性护理 (PAC) 后出院的再入院人数较高,但直接比较有限.

研究的目的:

为了比较三个排放组的初级TSA后180天的再入院率:常规家庭排放,HHC和PAC设施.
确定与TSA后的180天再接收相关的独立风险因素.

主要方法:

从2010年至2020年使用全国再接收数据库 (NRD).
包括所有接受初级TSA的患者.
采用二进制物流回归来分析再接收率和风险因素.

主要成果:

从2010年至2020年分析了171,898个TSA初级病例.
排放比例:71%是常规家庭,21%是HHC,8%是PAC设施.
在调整人口统计和并发症后,PAC设施的排放独立预测了180天的再接收 (OR: 1.69,CI: 1.59-1.79,P < .001).

结论:

与HHC或常规家庭出院相比,在PAC设施出院的患者在TSA后的再接收率显著更高.
即使控制了关键的人口和临床因素,这些发现仍然存在.
临床医生应该仔细考虑出院选择,为合适的患者提供家庭出院,以改善结果并与基于价值的护理计划保持一致.

关键词:

肩膀肩膀在肩膀上关节质复原关节质复原关节质复原关节质复原包装护理是一套的护理.家庭医疗保健家庭医疗保健在急性病后的护理.再接纳是指重新接纳的情况.

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