农村医院关闭后手术质量和获取的变化
Cody Lendon Mullens1,2,3, Patrick L Johnson1,2, Janice C Probst4
1Department of Surgery, University of Michigan, Ann Arbor, MI 48109, United States.
农村医院关闭不会影响手术质量,但会增加需要手术的患者的旅行距离. 这突显了美国农村地区及时获得手术护理的挑战,需要政策干预.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 农村卫生 农村卫生
- 外科手术的结果
背景情况:
- 农村医院关闭引发了人们对医疗保健获取和质量的担忧.
- 具体而言,对外科护理的影响仍未得到充分研究.
研究的目的:
- 评估农村医院关闭与外科手术质量和获取之间的关联.
- 分析医院关闭后常见外科手术的结果.
主要方法:
- 使用的医疗保险索赔数据从2010年到2020年.
- 采用了动态差异差异方法.
- 分析了那些无法进入他们最近或第二最近的农村医院进行大肠切除术,大肠切除术,尾切除术和修复的受益人.
主要成果:
- 没有发现对手术质量的重大影响,包括30天死亡率,并发症,重新手术和再入院.
- 患者失去最近的医院 (13.1至16.4英里) 的中位数旅行距离增加,但对于那些失去最近的第二家医院的患者而言没有增加.
- 非计划性手术的发生率保持不变.
结论:
- 农村医院关闭似乎不会影响外科手术的质量.
- 由于旅行距离的增加,关闭确实对及时获得手术护理提出了挑战.
- 政策制定者应该制定干预措施,以解决农村手术护理的差异.
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