在SaarPHIR项目中评估的养老院跨专业护理理念的影响:一个集群随机对照试验
Lisa Tönnies1, Viola Zimmer1, Alexandra Piotrowski2
1Center for Health Economics and Health Services Research - Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany.
PloS one
|May 15, 2025
概括
养老院的专业间合作并没有显著减少整体住院病例,但却减少了养老院护理敏感的入院病例. 较低的参与度限制了对这种护理概念的最终结论.
科学领域:
- 医疗保健管理的管理
- 老年学是一门学科.
- 公共卫生 公共卫生
背景情况:
- 养老院的专业间合作缺陷可能导致住院居民的护理不够优,住院住院也可能是可以预防的.
- 医院转移和住院带来感染和功能衰退等风险,强调需要改善护理协调.
- 萨尔菲尔 (SaarPHIR) 项目旨在加强全科医生和护士之间的合作,以提高护理质量并减少在养老院住院的住院次数.
研究的目的:
- 评估在养老院实施的专业间护理理念的有效性.
- 评估改善全科医生和护士之间的合作对住院住院和护理质量的影响.
主要方法:
- 一个前性,集群随机对照试验,涉及德国萨尔兰州的44个养老院.
- 该研究利用索赔数据来评估住院病例,分析采用通用线性混合模型.
- 二级结局包括门诊护理敏感的入院,死亡率,住院日数和健康经济方面.
主要成果:
- 干预和通常护理组之间的住院率没有显著差异 (IRR = 0.94).
- 在干预组中,对养老院护理敏感的入院病例显著减少 (IRR:0.73).
- 死亡率或住院日数没有显著差异;然而,干预组中平均药物成本增加,门诊住院成本下降.
结论:
- 在研究期间,专业间护理概念没有显著影响所有原因的住院治疗.
- 通过减少对养老院护理敏感的入院患者的减少,表明了积极的影响,这需要进一步调查.
- 干预组参与率低于预期,这可能限制了这项研究的力量和通用性.
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