心脏康复指标的医院级变化
Lisa M Pollack1, Anping Chang1, Michael P Thompson2
1Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
American heart journal
|December 15, 2024
概括
心脏康复 (CR) 护理在各医院之间存在显著的国家差异,老年,少数民族和女性患者的入学率较低. 医院的特点也影响CR参与,突出质量改善的领域.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 心脏康复 (CR) 对于心脏事件后的恢复至关重要.
- 了解CR交付的医院级差异对于全国质量改善至关重要.
研究的目的:
- 描述CR指标在国家,医院一级的变化.
- 通过医院的心脏护理层来分层CR指标.
- 为了确定与CR指标相关的患者和医院因素.
主要方法:
- 对Medicare FFS数据 (2018-2020) 和AHA数据 (2018) 的回顾性队列分析.
- 包括65岁以上的急性心肌梗塞 (AMI),皮肤冠状动脉干预 (PCI) 或冠状动脉旁路移植 (CABG) 的受益者.
- 医院按心脏护理层分层:综合,AMI/PCI,只有AMI.
主要成果:
- 在CR入学 (中位数为19.6%),入学时间 (中位数为55天),会议 (中位数为26) 和完成 (中位数为26%) 的实质性变化.
- 在每个心脏护理层内存在显著的差异.
- 较低的CR入学率与年龄较大,女性性别,非白人种族/种族,营利性所有权,非中西部地区,农村位置和更大的医院规模有关.
结论:
- 这是对医疗保险受益人中CR指标的首次全国性,医院级分析.
- 医院层之间和医院内部CR指标的显著变化表明质量改善的机会.
- 需要有针对性的策略来改善CR转诊和参与,特别是对于代表性不足的患者群体.
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