从PICU直接回家后返回护理:一个倾向匹配的队列研究
Leslie A Dervan1,2, Julia A Heneghan3, Matt Hall4
1Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington, Seattle, WA.
概括
从儿科重症监护室 (PICU) 直接出院的儿童的返回急诊室 (ED) 和再录取率与转移到急症监护室的儿童相似. 这种方法提供了潜在的医疗保健系统效率.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 医疗服务研究 医疗服务研究
- 医院出院的结果
背景情况:
- 儿科重症监护室 (PICU) 患者的出院途径各不相同,有些人直接回家,有些人在出院前转移到急症病房.
- 了解这些不同出院策略的比较结果对于优化患者护理和医疗资源利用至关重要.
研究的目的:
- 为了比较从PICU直接出院的儿科患者在14天内返回急诊室 (ED) 或重新入院的比例,与在出院前转移到急症病房的儿科患者相比.
- 评估这两种出院途径的相关医疗保健成本.
主要方法:
- 进行了一项倾向匹配的多中心队列研究,使用了参与儿科健康信息系统数据库的45家美国医院的数据.
- 该研究包括在2016年至2023年期间被录入非新生儿心脏或一般PICU的儿童.
- 倾向性得分匹配被用来比较直接出院的孩子和被转移到病房的孩子,控制入院年,类型和主要诊断等因素.
主要成果:
- 在560,815名PICU出院者中,有26.8%的人直接出院到家.
- 与病房转移的同龄人相比,直接出院的儿童有类似的返回ED护理 (2.9%与3.0%) 和14天住院再入院 (4.8%与4.9%) 的比例.
- 然而,直接出院的儿童更有可能被重新录取到PICU (2.4%对1.6%),他们的住院费用指数较低,导致14天内整体住院医疗费用减少.
结论:
- 从PICU直接出院是常见的做法,并且与通过急症病房出院而返回护理的比率相似.
- 虽然直接出院的患者更频繁地重新入住PICU,但整体医疗保健成本较低.
- 从PICU直接送回家可能是适合儿科患者的有效策略,需要考虑医疗保健系统优化.
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