随着COVID-19大流行,美国熟练护理设施能力的变化
Brian E McGarry1, Andrew D Wilcock2, Ashvin D Gandhi3
1Department of Medicine, University of Rochester, New York.
JAMA internal medicine
|January 12, 2026
概括
熟练护理设施 (SNF) 的运营能力在流行病后下降,与人员短缺有关. 这种SNF床位的减少影响了医院出院,增加了患者的住院时间和旅行距离.
科学领域:
- 医疗保健管理的管理
- 老年学是指老年学的学科.
- 公共卫生 公共卫生
背景情况:
- 熟练的护理设施 (SNFs) 对于急性后护理至关重要.
- 报告显示,SNF在COVID-19后的产能减少,影响了护理和医院出院的机会.
- 对这些变化的经验证据仍然有限.
研究的目的:
- 量化2020年后SNF容量的变化.
- 评估SNF能力变化,人员短缺和医院出院结果之间的关联.
主要方法:
- 使用2018-2024年医疗保险和医疗补助服务中心的工资基础期刊数据进行横截面研究.
- 对SNF容量趋势的描述性分析.
- 进行回归分析,以检查SNF能力,人员短缺和解雇结果之间的关联.
主要成果:
- 在2019-2024年期间,SNF运营能力下降了5.0% (许可床位下降了2.5%),地理差异很大.
- 在农村地区和经常出现人员短缺的县,产能下降更为明显.
- 减少SNF容量与增加住院时间,延长住院时间和更长的患者旅行距离相关.
结论:
- 疫情后,SNF的运营能力大幅下降,超过了许可床位的减少,这可能是由于人员问题.
- 降低SNF容量似乎会损害获得急性后护理的机会.
- 这些发现凸显了需要解决SNF人员和能力问题,以确保护理的连续性.
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