农村医院关闭与急性和后急性护理接入和结果之间的关联
Geoffrey J Hoffman1,2, Jinkyung Ha3, Zhaohui Fan4
1University of Michigan School of Nursing, Ann Arbor, Michigan, USA.
Health services research
|December 31, 2024
概括
农村医院关闭并没有恶化医疗保健的获得或患者的结果. 关闭可能促使护理调整,导致患者寻求更高质量的服务.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 农村卫生政策 农村卫生政策
- 医疗保健经济学 医疗经济学
背景情况:
- 农村医院为弱势群体提供服务,通常以较低的利率运作.
- 医院关闭可能会影响缺乏服务的地区的医疗保健和患者结果.
研究的目的:
- 调查农村医院关闭对医院利用率,急性后护理 (PAC) 使用和患者结局的影响.
- 分析关闭后旅行距离,停留时间,功能限制和再接收率的变化.
主要方法:
- 使用分阶差异设计分析了32家农村医院关闭的数据.
- 使用了大约300万老年人的医疗保险索赔和临床数据.
- 评估住院率,住院时间,PAC利用率和再接收率的变化.
主要成果:
- 关闭的医院为更多的少数群体,低收入人群提供服务,利率较低.
- 季度住院率和平均住院时间在关闭后增加.
- 没有观察到旅行距离,功能限制或PAC启动时间的显著变化. 孤立的医院关闭与重新入院的可能性增加有关.
结论:
- 农村医院关闭并没有导致医疗保健获得,功能或健康结果明显恶化.
- 护理提供调整和寻求更高质量的护理的患者可能会减轻负面影响.
- 调查结果表明,尽管农村医院关闭,但医疗保健系统仍有弹性.
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