临床医生在护理院接受急性后护理的患者中的体积和结果
Brandi Peacock1, Seiyoun Kim1, Ziwei Pan1
1Division of General Internal Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
JAMA network open
|August 15, 2025
概括
养老院的临床患者数量没有影响急性护理后的治疗结果,如重新入院或出院的成功. 这项研究发现,基于治疗临床医师小组规模,患者的治疗结果没有显著差异.
科学领域:
- 老年病的医生 老年病的医生
- 医疗保健服务研究 医疗服务研究
- 临床结果 临床结果
背景情况:
- 医生和高级从业医生的患者数量对美国养老院急性后护理结果的影响尚不清楚.
- 在养老院环境中优化患者护理和资源配置需要了解影响结果的因素.
研究的目的:
- 调查医生和高级从业人员的患者数量与养老院急性护理后患者结果之间的关联.
- 为了确定临床医生的面板大小是否与养老院居民的关键质量指标相关.
主要方法:
- 一项回顾性队列研究,利用医疗保险A部分和B部分索赔和2012-2019年最低数据集 (MDS) 数据.
- 包括65岁以上的医疗保险收费服务受益者,在养老院接受急性后护理,由医生或高级从业人员看病.
- 通过Poisson回归模型,分析了临床医生患者数量 (分类为分数) 和结果之间的关联,包括30天的再住院,急救访问,成功的社区出院和功能状态改善.
主要成果:
- 对超过600万个患者年进行的分析显示,在30天的再住院,急救诊所访问,成功的社区出院或临床医生在最低与最高患者体积分值中看到的患者之间的功能改善之间,没有统计学上显著的差异.
- 再住院 (1.05),成功出院 (0.96),急救诊所 (1.03) 和功能改善 (0.96) 的发生率比率在体积分值中没有显著变化.
结论:
- 这项研究发现,临床医师小组规模和医疗保险受益者在养老院的急性后护理结果之间没有关联.
- 这些发现表明,目前在养老院提供护理的模式可能不会受到个人临床医生管理的患者数量的显著影响.
- 结果可以为未来的护理模式的发展提供信息,并为在养老院环境中执业的临床医生提供质量改进计划.
相关概念视频
01:29Documentation in Long-Term and Home Healthcare Setting
976
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
976
01:21Planning Nursing Care I
4.7K
The planning phase of the nursing process helps nurses set priorities, outline patient-centered goals and expected outcomes, and tailor nursing interventions to align with the aligned care plan. Through the planning phase, the nurse applies critical thinking skills to align and develop interventions according to the patient's needs. It provides continuity of care allowing patients to receive the maximum benefit from treatment. It serves as a pilot plan for allocating individual staff to a...
4.7K
01:15Nursing Evaluation
3.5K
The evaluation stage signals the end of the nursing process. The nurse gathers evaluative data to assess whether or not the patient has attained the expected results. Whereas the nurse collects data in the nursing assessment to identify the patient's health concerns, the evaluation stage data determines if the indicated health issues are resolved. Evaluative data collection includes two sections: the data acquired to evaluate patient outcomes and the time criteria for data collection.
3.5K
01:11Guidelines for Writing Outcome
3.0K
When developing expected outcomes for a patient care plan, the nurse should adhere to the following recommendations:
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
3.0K
01:08Role of Communication in the Nursing Process III: Evaluation and Documentation
1.4K
A successful patient outcome depends mainly on the evaluation stage of the nursing process. Evaluation determines effectiveness by reviewing what was done previously after the completion of nursing interventions. Every time a healthcare professional steps in or administers treatment, they must reassess or evaluate the action to ensure the intended result. During the evaluation phase, there are three probable patient outcomes:
1.4K
01:29Planning Nursing Care II
2.9K
A nursing care plan can present in two forms: informal and formal. Informal is a care plan for the individual use of the nurse and goals they wish to accomplish during their shift. Informal care plans are not included in the patient chart. A formal nursing care plan is a written or computerized guide that organizes patient care. It is further subdivided into two: standardized and individualized care plans. Standardized care plans are pre-populated care plans for specific patient populations,...
2.9K