熟练护理机构使用和心脏手术后的结果的差异
Yoyo Wang1, James W Stewart2, Hechuan Hou1
1Department of Cardiac Surgery, Michigan Medicine, Ann Arbor, Michigan.
The Journal of surgical research
|November 23, 2024
概括
黑人女性和白人女性在心脏手术后更有可能使用熟练护理设施 (SNF). 然而,在SNF释放后的1年生存益处并不反映这些性别和种族差异.
科学领域:
- 心血管外科心血管外科
- 医疗保健服务研究 医疗服务研究
- 健康差异 在健康上的差异
背景情况:
- 心脏手术与高发病率有关,需要广泛的术后护理.
- 熟练的护理设施 (SNFs) 越来越多地被用于心脏手术后的成本管理.
- 现有的研究不足地解决了心脏手术后SNF利用的性别和种族差异.
研究的目的:
- 在冠状动脉旁路移植 (CABG) 后,调查性别,种族和熟练护理设施利用之间的关联.
- 评估性别和种族对心脏手术后出院到SNFs的患者结果的影响.
主要方法:
- 对2016年6月至2018年12月期间接受CABG的患者的医疗保险提供者分析和审查数据的分析.
- 患者分为四组:白人男性,白人女性,黑人男性和黑人女性.
- 后勤回归和考克斯比例危险分析,以评估SNF使用和相关结果.
主要成果:
- 与黑人男性 (24.9%) 和白人男性 (18.9%) 相比,黑人女性 (37.1%) 和白人女性 (33.7%) 的SNF排泄率最高.
- 调整后的分析显示,与白人男性相比,黑人男性,白人女性和黑人女性的SNF排泄率更高.
- 与白人男性相比,被释放到SNF的白人女性和黑人女性的整体存活率有所改善.
结论:
- 在心脏手术后,SNF利用在性别和种族类别之间存在显著的差异.
- 风险调整后的一年死亡结果与在SNF使用中观察到的差异不一致.
- 需要进一步的研究来理解和解决心脏手术患者的性别,种族和急性后护理利用的复杂相互作用.
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