在五个高收入国家的关节骨折护理区域化
Pieter Bakx1, Carlos Godoy1, Saeed Al-Azazi2,3
1Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, PA, the Netherlands.
Health services research
|June 24, 2025
概括
关节骨折护理的区域化在不同国家之间有很大差异. 集中护理与更好的患者结果之间的联系是不一致的,突出了需要量身定制的方法.
科学领域:
- 老年医学 老年医学
- 整形外科手术 整形外科手术
- 医疗保健服务研究 医疗服务研究
背景情况:
- 关节骨折护理往往是区域化的,集中治疗在专门的中心.
- 医院体积与患者结果之间的关系 (体积与结果关系) 是许多外科手术的确定的关系.
研究的目的:
- 为了比较五个不同国家的关节骨折护理的区域化情况.
- 调查这些国家的关节骨折治疗的体积-结果关系.
主要方法:
- 基于66岁以上的成年人使用行政数据 (2011-2019) 进行基于人口的横截面队列研究.
- 分析包括来自加拿大,以色列,荷兰,台湾和美国的数据.
- 医院按关节骨折治疗量分层;结果 (30天死亡率,非手术治疗) 根据年龄和性别标准化.
主要成果:
- 观察到关节骨折区域化在国际上有显著差异 (加拿大37.0%的医院,以色列为82.8%).
- 高人数的医院治疗关节骨折的数量是低人数医院的4-14倍.
- 大量护理与减少30天死亡率之间的关联有所不同,一些国家显示有好处 (例如加拿大),而另一些国家则没有或有害 (例如荷兰).
结论:
- 在全球范围内,关节骨折护理的区域化存在重大差异.
- 增加区域化和改善患者结果之间的预期积极关联在各国并未一致观察到.
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