在接受选择性住院下肢关节置换的老年医疗保险受益者中,预康复利用的患病率和特征
Jenni S Reiff1, Jennifer L Wolff1, John McGready2
1Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
Archives of physical medicine and rehabilitation
|July 18, 2025
概括
下肢关节置换 (LEJR) 的预康复从2016年到2019年增加,尽管大多数患者只接受了一次访问. 根据患者和设施的特点,接入方式有所不同,这凸显了进一步研究的必要性.
科学领域:
- 老年医学 老年医学
- 整形外科手术 整形外科手术
- 康复科学 康复科学 康复科学
背景情况:
- 预康复是下肢关节置换 (LEJR) 的日益增长的干预措施,旨在在手术前优化患者的功能.
- 了解预康复接收和交付的趋势对于改善患者的治疗结果至关重要.
研究的目的:
- 描述LEJR.预康复接收和交付的趋势和患者/设施因素.
- 根据脆弱性和关节类型,检查预康复服务属性 (时间,频率,持续时间).
主要方法:
- 追溯性队列研究,使用Medicare受益人 (≥65岁) 的行政索赔数据进行选择性住院LEJR (2016-2019).
- 在手术前30天内作为物理或职业治疗的预康复.
- 分析了预康收到和设施交付的流行率,特征和属性.
主要成果:
- 在2016年至2019年期间,预康复患病率从8.03%增加到11.14%.
- 大多数患者 (77%) 接受了一次门诊;非脆弱膝关节置换患者的增幅最大.
- 接收因患者人口统计学/社会经济学而异;设施交付因设施特征而异.
结论:
- 使用LEJR预康复正在增加,但使用模式和访问障碍需要进一步调查.
- 了解实施因素和优化预康复策略对于这种不断变化的服务交付模式至关重要.
相关概念视频
Peripheral Artery Disease V: Postoperative Nursing Management
26
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
26
Peripheral Artery Disease III: Interprofessional Care
30
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
30
Peripheral Artery Disease I: Introduction
34
Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
34
Peripheral Artery Disease IV: Nursing Management
46
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
46


