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在二级保健中未编码的慢性病患病率:具有人口健康影响的回顾性审计
Samantha Dolan1, Ajitesh Anand2, Philip A Kalra3
1Rochdale Care Organisation, Northern Care Alliance NHS Foundation Trust, Rochdale, England.
未被诊断的慢性病 (CKD) 在医院中很常见,超过一半的病例未被编码. 在二级护理中改进CKD编码可以提高患者管理,减少急性损伤 (AKI) 等风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 改善医疗保健质量 改善医疗保健质量
- 公共卫生 公共卫生
背景情况:
- 据估计,英格兰约有100万人患有未诊断的慢性病 (CKD).
- 慢性病的临床编码与更好的患者管理和急性损伤 (AKI),非计划护理和死亡率降低的风险有关.
- 虽然初级保健在CKD编码中的作用是公认的,但对二级保健编码质量的证据是有限的.
研究的目的:
- 为了确定编码和未编码的CKD在入院和出院时的流行率.
- 评估二级护理中从未编码到编码的CKD转换率.
- 探索CKD编码,死亡率和AKI的预测因素,并将编码状态映射到健康不平等.
主要方法:
- 在2022年4月至2023年2月期间,在英国一家急性医疗病房进行了回顾性审计.
- 描述性统计数据,包括流行率和估计率,用于分析数据.
- 后勤回归确定了CKD在出院时编码,入院期间死亡和AKI的显著预测因素 (p <0.05).
主要成果:
- 未编码的CKD的患病率,通过排泄估计的膜过率 (eGFR) 来确定,为58.7%.
- 排放时未编码到编码的CKD的转换率很低,仅为6.7%.
- 高血压和晚期CKD预测了以前未被编码的患者的编码,而年龄,性别,贫困和AKI预测了死亡. 先进的CKD预测了AKI的发生.
结论:
- 在急性医疗医院环境中存在高患病率的未编码的CKD.
- 在中等保健中,有很大的机会改善CKD编码实践,补充初级保健的努力.
- 在医院中加强CKD编码可能会改善患者的治疗结果,并减少医疗保健负担.
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