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退伍军人熟练护理设施中医院后护理的变化:一个队列分析
Robert E Burke1,2,3, Tom Cidav4, Andrew Tjader5
1Center for Healthcare Evaluation Research and Promotion, Corporal Crescenz VA Medical Center, Philadelphia, PA, USA. Robert.Burke5@va.gov.
Journal of general internal medicine
|January 26, 2026
概括
在政策更新和COVID-19大流行后,退伍军人熟练护理设施 (SNF) 的使用发生了重大变化. 医疗保险支付的非VASNF仍然是最常见的,但结果因设施类型而异.
科学领域:
- 老年学是一门学科.
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
背景情况:
- 美国的美国. 退伍军人人口正在老龄化,对熟练护理设施 (SNF) 的需求正在增加.
- 了解SNF利用趋势对于满足老年退伍军人的需求至关重要.
研究的目的:
- 检查退伍军人住院后SNF使用在2018年"使命法"和COVID-19大流行之前和之后的变化.
- 确定影响SNF配置的因素,并比较不同SNF类型的结果.
主要方法:
- 追溯的队列研究超过140万66岁以上的退伍军人从2015年至2022年被录取到SNF.
- 分析SNF利用趋势,影响SNF类型选择的因素和患者的治疗结果.
- 对VA社区生活中心 (CLC),VA支付的合同养老院 (CNH) 和Medicare支付的非VASNF的结果进行比较.
主要成果:
- 医疗保险支付的非VA SNF占过渡的90%;CLC和CNH分别占5.8%和4.2%.
- 在2019年后,CNH的使用增加了,而在COVID-19期间,SNF的整体使用急剧下降.
- 退伍军人医院将退伍军人指向VA SNF,非VA医院指向非VA SNF;CLC的再入院率较高,但死亡率较低.
- 国家医疗保健机构的平均停留时间更长,长期护理率更高.
结论:
- 退伍军人SNF利用模式在"使命法"和COVID-19之后演变,根据SNF类型产生不同的结果.
- 调查结果强调需要分析医院的特点和政策如何影响老年退伍军人的急性后护理获取,质量和成本.
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