在退伍军人卫生管理局社区生活中心实施INTERACT:一个务实的随机试验
Vincent Mor1,2, Debra Saliba3,4, Orna Intrator5,6
1Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Journal of the American Geriatrics Society
|December 4, 2024
概括
在VA社区生活中心 (CLC) 引入干预以减少急性护理转移 (INTERACT) 计划并没有显著降低住院率. 较少的不适当转移和CLC的更高的人员数量可能解释了缺乏影响.
科学领域:
- 老年学是一门学科.
- 医疗保健管理的管理
- 改善临床质量 改善临床质量
背景情况:
- 从VA社区生活中心 (CLC) 到医院的转移很频繁.
- 该研究评估了干预减少急性护理转移 (INTERACT) 计划对这些转移的影响.
研究的目的:
- 评估INTERACT计划在减少来自VA CLC的住院治疗方面的有效性.
- 分析潜在的不恰当和可预防的转移决策的变化.
主要方法:
- 在16个配对的VA CLC中进行了集群随机试验.
- 干预CLC工作人员接受了INTERACT工具的培训,其中一个工具集成到VA电子医疗记录中.
- 在18个月的时间里,每两周向干预人员提供一次支持电话.
主要成果:
- 在八个干预CLC中,只有五个显示出与INTERACT计划的实质性参与.
- 干预和控制CLC之间没有观察到任何原因住院率的统计学上显著差异.
- 结构化记录审查表明,干预前后的干预CLC中不适当的转移决定率很低.
结论:
- 互联互动计划并没有减少VA CLC中因各种原因住院的病例.
- 与社区养老院相比,VA CLCs的住院率较高,但不适当的转移率较低.
- 诸如低不合适的转移率和CLC高的人员水平等因素可能限制了INTERACT的实施和影响.
关键词:
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