家庭出院成功与住院后护理计划之间的关联:跨部门生态研究
Naoki Takashi1, Misaki Fujisawa1, Shosuke Ohtera1
1Department of Health Economics, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan.
JMIR formative research
|December 12, 2024
概括
在日本,有效的排放规划增加了家庭排放,但显示出显著的区域差异. 解决这些差距是公平护理转型和改善患者结果的关键.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
背景情况:
- 有效的出院规划对于成功的护理过渡至关重要,旨在减少住院和再入院.
- 日本对复杂患者住院后护理计划协调的财政激励措施对国家影响不清楚.
- 了解出院计划的区域差异对于优化护理过渡至关重要.
研究的目的:
- 评估日本县级退院计划申请与医疗保健结果 (家庭退院,再入院,住院时间,医疗费用) 之间的关联.
- 描述住院后护理规划的区域差异.
- 探索与排放规划的区域差异相关的因素.
主要方法:
- 使用2020财年日本县级数据进行的生态研究.
- 为排放计划索赔计算出供应调整的标准化索赔比率 (SCR),以考虑人口结构.
- 使用多变量负二项回归和曼-惠特尼U测试来分析SCR,结果和区域因素之间的关联.
主要成果:
- 在排放规划规定中观察到显著的区域差异 (最小-最大SCR比率为10.63).
- 排放规划较高的SCR与对家庭的排放增加有关.
- 诸如护士可用性,护理经理密度,电子健康信息共享,独居老年人比例和人均收入等因素影响了区域SCR.
结论:
- 住院后的护理计划与出院到家的可能性更高有关,这突显了它在护理过渡中的重要性.
- 在护理协调方面存在显著的区域差异,需要针对性干预,以获得公平的医疗保健结果.
- 需要进一步的研究来阐明这些观察到的关联背后的因果关系.
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