养老院评级和特征预测严重疾病的死者中临终关怀的使用情况
Ellis Dillon1, Chae Man Lee2, Wenqi Gan3
1Center on Aging, University of Connecticut School of Medicine, Farmington, CT, USA; Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA.
Journal of the American Medical Directors Association
|February 6, 2026
概括
养老院 (NH) 的特点对终身护理有影响. 高质量的NH,特别是那些有更好的医疗保险和医疗补助服务中心 (CMS) 评级的NH,与长期NH居民的住院使用率较低有关.
科学领域:
- 老年学和息护理研究研究
- 医疗保健服务研究 医疗服务研究
- 养老院的质量和终身护理
背景情况:
- 显著比例的老年人利用养老院 (NHs) 接近生命的尽头.
- 了解NH特征如何影响终身临终关怀的利用对于改善关怀质量至关重要.
- 之前的研究还没有完全阐明特定的NH属性与临终医院接入之间的关联.
研究的目的:
- 调查老年人中养老院特征与宿舍利用之间的关系.
- 检查NH质量评级和设施类型等因素如何与宿舍使用和持续时间有关.
主要方法:
- 使用医疗补助和传统医疗保险索赔数据进行回顾性队列研究.
- 包括最低数据集 (MDS) 信息,医疗保险和医疗补助服务中心 (CMS) 护理比较评级和其他NH特征.
- 多变量后勤回归分析是从康涅狄格州医疗补助保险死亡者的数据进行的,死亡后六个月内NH停留.
主要成果:
- 总体而言,49.2%的研究受试者接受了临终关怀,38.3%的临终关怀时间短 (≤7天).
- 长期的NH停留与临终关怀使用和短期临终关怀使用的几率增加有关.
- 较高的CMS质量评级和NH的员工评分与长期住院居民使用临终关怀的几率较低有关. 相反,在卫生检查评级高的国民医疗机构短期住院的患者,住院使用率较低.
结论:
- 养老院的特点,特别是CMS的质量评级,与长期住院居民的住院使用相反相关.
- 这些发现表明需要进一步研究NH质量指标与终身护理,特别是宿舍整合之间的相互作用.
- 应该考虑将终生质量措施纳入未来的CMS养老院质量评级.
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