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评估行政合规作为美国养老院灾后结果的预测指标
Natalia Festa1,2, Kaitlin F Throgmorton3, Manali A Phadke4
1Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
养老院遵守应急准备标准并没有预测风迈克尔之后居民的结果. 建筑规范的缺陷,而不是应急准备,与功能衰退有关,这表明需要在灾害响应监督中更好地协调.
科学领域:
- 公共卫生 公共卫生
- 老年学是指老年学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 评估符合医疗保险和医疗补助服务中心 (CMS) 应急准备标准,对于灾难期间护理院居民的安全至关重要.
- 迈克尔风提供了一个现实世界的场景,以评估这些标准对灾后结果的影响.
研究的目的:
- 确定是否遵守CMS应急准备标准可以保护养老院居民免受重大风后的不利后果.
- 识别特定的监管缺陷,预测灾后死亡率,住院和功能衰退.
主要方法:
- 一项回顾性队列研究分析了294个养老院和21000多名暴露在迈克尔风中的居民.
- 一般化的线性模型和弹性网规范化确定了30天死亡率,30天住院和120天功能衰退的预测因素.
- 超过200个独特的缺陷被运用为指标变量,以评估它们的预测能力.
主要成果:
- 没有应急准备 (E-tag) 缺陷预测了不利的居民结果.
- 两个建筑规范 (K-tag) 的缺陷与灾后功能衰退的风险增加有关.
- 与基线相比,模型在预测死亡率和功能衰退方面显示出最小的,不显著的改善.
结论:
- 遵守联邦应急准备标准与灾后居民改善的结果没有相关性.
- 建筑规范的遵守似乎比应急准备更为关键,以减轻功能衰退.
- 目前对养老院应急准备的监督和测量可能不能充分反映现实世界的灾难响应需求.
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