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本文引用的文献

1
Do trends in the reporting of quality measures on the nursing home compare web site differ by nursing home characteristics?疗养院比较网站上质量指标报告的趋势是否因疗养院特征而异？
Gerontologist. 2005 Dec;45(6):720-30. doi: 10.1093/geront/45.6.720.
2
Outcomes and reimbursement of inpatient rehabilitation facilities and subacute rehabilitation programs for Medicare beneficiaries with hip fracture.髋部骨折医疗保险受益人的住院康复机构和亚急性康复项目的治疗结果与报销情况。
Med Care. 2005 Sep;43(9):892-901. doi: 10.1097/01.mlr.0000173591.23310.d5.
3
Are we selecting the right patients for stroke rehabilitation in nursing homes?
Arch Phys Med Rehabil. 2005 May;86(5):876-80. doi: 10.1016/j.apmr.2004.10.045.
4
The effect of Medicare's prospective payment system on discharge outcomes of skilled nursing facility residents.医疗保险的前瞻性支付系统对专业护理机构居民出院结果的影响。
Inquiry. 2004;41(4):418-34. doi: 10.5034/inquiryjrnl_41.4.418.
5
How much is postacute care use affected by its availability?急性后期护理的可获得性对其使用情况有多大影响？
Health Serv Res. 2005 Apr;40(2):413-34. doi: 10.1111/j.1475-6773.2005.00365.x.
6
Nursing home consumer complaints and their potential role in assessing quality of care.养老院消费者投诉及其在评估护理质量方面的潜在作用。
Med Care. 2005 Feb;43(2):102-11. doi: 10.1097/00005650-200502000-00003.
7
2002 National Hospital Discharge Survey.2002年全国医院出院调查。
Adv Data. 2004 May 21(342):1-29.
8
An assessment of strategies for improving quality of care in nursing homes.养老院护理质量提升策略评估
Gerontologist. 2003 Apr;43 Spec No 2:19-27. doi: 10.1093/geront/43.suppl_2.19.
9
Converging on nursing home quality.
NHPF Issue Brief. 2003 Jan 9(787):1-6.
10
Identification and evaluation of existing nursing homes quality indicators.现有养老院质量指标的识别与评估。
Health Care Financ Rev. 2002 Summer;23(4):19-36.

疗养院质量措施和质量指标在评估专业护理机构康复结果中的作用。

Usefulness of the nursing home quality measures and quality indicators for assessing skilled nursing facility rehabilitation outcomes.

作者信息

Silverstein Burton, Findley Patricia A, Bode Rita K

机构信息

HCR Manor Care, Toledo, OH 43604, USA.

出版信息

Arch Phys Med Rehabil. 2006 Aug;87(8):1021-5. doi: 10.1016/j.apmr.2006.05.001.

DOI:10.1016/j.apmr.2006.05.001
PMID:16876545
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1861822/
Abstract

OBJECTIVE

To examine the usefulness of the nursing home quality indicators and nursing home quality measures for differentiating among providers from a rehabilitation outcomes perspective.

DESIGN

Retrospective.

SETTING

Skilled nursing facilities (SNFs) across the United States.

PARTICIPANTS

A total of 211 SNFs.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

All quality indicators, all quality measures except for CWLS01 (residents who lose too much weight), and a set of rehabilitation outcomes including residualized FIM motor gain, the percentage of patients discharged to community, and the percentage of patients reporting "quite a lot" or "completely" prepared to manage their care at discharge from SNF-based rehabilitation.

RESULTS

No quality measures correlated with any rehabilitation outcomes. Residualized FIM motor gain did not correlate with any quality indicators or quality measures. Only 1 quality indicator-prevalence of daily use of restraints (QI 22)-correlated with the rehabilitation indicator community discharge percentage. The third rehabilitation indicator, prepared to manage care at discharge, correlated (negatively) only with QI 18 incidence of decrease in range of motion. Among the rehabilitation outcomes, residualized FIM motor gain correlated significantly with both community discharge percentage and prepared to manage care at discharge.

CONCLUSIONS

Patients and referrers choosing SNF-based medical rehabilitation need tools that differentiate among prospective providers from a rehabilitation outcomes perspective. Data in this study indicate that nursing home quality indicators and quality measures are inadequate for this purpose.

摘要

目的

从康复结局的角度，检验疗养院质量指标和疗养院质量衡量标准在区分服务提供者方面的有用性。

设计

回顾性研究。

地点

美国各地的专业护理机构（SNFs）。

参与者

总共211家SNFs。

干预措施

不适用。

主要结局指标

所有质量指标、除CWLS01（体重减轻过多的居民）外的所有质量衡量标准，以及一组康复结局指标，包括FIM运动功能残余增益、出院至社区的患者百分比，以及在基于SNF的康复出院时报告“非常多”或“完全”准备好管理自身护理的患者百分比。

结果

没有质量衡量标准与任何康复结局相关。FIM运动功能残余增益与任何质量指标或质量衡量标准均无相关性。只有1个质量指标——日常使用约束措施的患病率（QI 22）——与康复指标社区出院百分比相关。第三个康复指标，即出院时准备好管理护理，仅与QI 18（关节活动范围减小发生率）呈负相关。在康复结局中，FIM运动功能残余增益与社区出院百分比和出院时准备好管理护理均显著相关。

结论

选择基于SNF的医疗康复的患者和转诊者需要从康复结局角度区分潜在服务提供者的工具。本研究中的数据表明，疗养院质量指标和质量衡量标准在此目的上并不充分。