退伍军人接受年龄友好型卫生系统的住院后结果 4M Care
Thomas A Bayer1,2, Malisa Barber1, Christopher Halladay1
1Transformative Health Systems Research to Improve Veteran Equity and Independence Center of Innovation (THRIVE), Providence VA Healthcare System, Providence, Rhode Island, USA.
Journal of the American Geriatrics Society
|October 17, 2025
概括
年龄友好型卫生系统 (AFHS) 护理,包括4Ms (重要的是什么,药物,流动性和心理) 评估,减少了退伍军人的30天再入院. 这项研究支持在住院患者环境中实施基于证据的AFHS实践.
科学领域:
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
- 提高质量 提高质量
背景情况:
- 年龄友好型卫生系统 (AFHS) 倡议促进对医疗保健中的4M (重要的是什么,药物,流动性和指导) 的评估.
- 虽然4M是基于证据的,但对于接受全面4M评估的患者的结果存在有限的数据.
研究的目的:
- 评估住院AFHS护理,特别是4M评估对退伍军人的关键健康结果的影响.
- 确定AFHS护理是否影响30天再入院率,急诊室 (ED) 访问和死亡率.
主要方法:
- 在2022年1月至2024年12月期间,退伍军人在6个VA医疗中心接受治疗的退伍军人进行了回顾性匹配队列研究.
- 使用电子健康记录来识别具有4Ms评估记录的退伍军人,并将其与没有完整4Ms评估的对照进行匹配.
- 使用倾向性得分匹配,考虑设施,入院时间,人口统计和并发症. 分析的结果包括30天再入院,ED使用和使用卡普兰-梅尔和考克斯比例危险模型的死亡率.
主要成果:
- 该研究包括2420名接受4M护理的退伍军人和4688名匹配的对照.
- 纳入4M的AFHS护理与30天再入院的风险显著降低相关 (HR 0.67).
- 两组之间在30天的急诊室访问 (HR 0.95) 或死亡率 (HR 1.02) 中没有观察到统计学上显著的差异.
结论:
- 住院AFHS护理,包括4Ms评估,与退伍军人的30天再入院率下降有关.
- 这些发现表明,在住院医院中实施基于证据的AFHS实践可以改善患者的治疗结果.
- 进一步的研究可能会探索驱动回收减少的具体机制.
相关概念视频
Documentation in Long-Term and Home Healthcare Setting
1.4K
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
1.4K
Traditional Level Of Health Care System
3.3K
The levels of care describe the services provided in the healthcare system. Accordingly, there are six levels of the traditional healthcare system in the US: preventive, primary, secondary, tertiary, restorative, and continuing healthcare. A nurse must understand how the healthcare industry organizes and provides services within these levels of care.
The preventive healthcare service includes tests for screening. Preventive health care services include identifying and reducing disease risk...
The preventive healthcare service includes tests for screening. Preventive health care services include identifying and reducing disease risk...
3.3K
Restorative Care
2.3K
Restorative care is provided once a patient has been discharged from a healthcare facility and requires additional services. The additional services include home care, rehabilitation programs, and extended care. Restorative care centers help the patient regain their previous level of functioning or acquire a new level of functioning due to the incapacitating effects of a disease or a disability. It aims to assist patients in enhancing their quality of life by encouraging independence,...
2.3K
Peripheral Artery Disease III: Interprofessional Care
237
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...
237
Tertiary Healthcare System
2.1K
Specialized care provided over an extended period is called tertiary care. Usually, a primary or secondary care physician will refer a patient to tertiary care. A patient's maximum physical and mental function is restored in tertiary care, which is caused due to the impact of a chronic illness or condition. Tertiary care aims to achieve the highest level of functioning possible while managing chronic illness. For example, a patient who falls and fractures their hip will need secondary care...
2.1K
Discharge Summary Forms
1.2K
The discharge summary is crucial as it enables a smooth transition from a healthcare facility to a patient's home or another care setting. This critical document facilitates seamless continuity of care, ensuring patients receive the necessary support and attention.
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
1.2K

