与慢性病患者意外入院相关的因素
Michael Gottlieb1, Natalia Golovashkina, Brian D Stein
1Department of Emergency Medicine, Rush University Medical Center, 1750 W Harrison St, Ste 108 Kellogg, Chicago, IL 60612.
The American journal of managed care
|June 25, 2025
概括
患有多种慢性病并无计划住院的患者,如果他们的并发病率得分,某些疾病或说西班牙语较高,风险更高. 初级保健访问和年度健康访问可以降低这种风险.
科学领域:
- 医疗保健的质量 医疗保健的质量
- 慢性疾病管理 慢性疾病管理
- 医疗保健服务研究 医疗服务研究
背景情况:
- 基于价值的护理模式强调质量指标,例如多重慢性病患者 (UAMCCs) 计划外入院.
- 确定UAMCCs的风险因素对于有针对性的干预和改善患者结果至关重要.
- 关于与UAMCCs最高风险相关的特定因素的数据有限.
研究的目的:
- 确定与多种慢性病患者 (UAMCCs) 意外入院风险增加相关的因素.
- 确定可能减少UAMCCs发病率的保护因素.
主要方法:
- 在中西部医疗保健系统中,对18448名患有≥2种慢性疾病的成年患者进行了回顾性研究 (2022年11月 - 2023年10月).
- 分析包括人口统计,慢性疾病,初级保健医生 (PCP) 访问利用率和年度健康访问 (AWV) 使用率.
- 使用多变量后勤回归来确定与UAMCCs的关联.
主要成果:
- 20.8%的患者至少经历过一次UAMCC.
- 与医疗保险/医疗补助保险,寡妇身份,西班牙语,较高的查尔森并发症指数以及包括阿尔茨海默病,心房动,心力衰竭,CKD,COPD和中风在内的疾病相关的风险更高.
- 年度健康检查和≥1次PCP检查与UAMCC的减少有关.
结论:
- 较高的并发症负担,特定的慢性疾病和西班牙语是UAMCCs的风险因素.
- 定期的初级保健参与,包括年度健康访问,表明对UAMCCs有保护作用.
- 结果可以为基于价值的护理中的有针对性的策略提供信息,以减轻UAMCCs.
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