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家庭远程医疗与医院再入院:一项回顾性OASIS-C数据分析

Home telehealth and hospital readmissions: a retrospective OASIS-C data analysis.

作者信息

Thomason Tanna R, Hawkins Shelley Y, Perkins Katherine E, Hamilton Elissa, Nelson Betty

机构信息

Tanna R. Thomason, MS, RN-BC, CNS, CCRN, PCCN, is a PhD Student, Hahn School of Nursing and Health Science, University of San Diego, San Diego, California. Shelley Y. Hawkins, PhD, FNP-BC, GNP, FAANP, is an Associate Professor and Director, DNP & MSN NP Programs, Hahn School of Nursing and Health Science, University of San Diego, San Diego, California. Katherine E. Perkins, BAN, RN, is a Quality Nurse Manager, Palomar Home Health Services, Escondido, California. Elissa Hamilton, BSN, MBA, NE-BC, is the Director, Palomar Home Health Services, Escondido, California. Betty Nelson, BSN, RN, is a CAHSAH-certified Manager, Palomar Home Health Services, Escondido, California.

出版信息

Home Healthc Now. 2015 Jan;33(1):20-6. doi: 10.1097/NHH.0000000000000167.

Abstract

Technology holds potential to improve the quality of healthcare delivery. The use of remote patient monitoring, or telehealth (TH), has been widely adopted by many home care agencies to facilitate early identification of disease exacerbation, particularly for patients with chronic diseases such as heart failure. TH has been successfully used to improve symptom detection and potentially reduce rehospitalization rates. Quantifying program effectiveness through data analysis is a critical step for program improvement, resource allocation, and future strategic planning. Using the Outcome and Assessment Information Set-C database, a retrospective analysis was conducted examining 22 months of heart failure patient data from one home care agency in southern California. Seventy patients receiving TH were compared to patients who received usual home care nursing services. No major differences in baseline socio-demographics were found between the 2 groups. While receiving home healthcare services, the non-TH patients had a 21% all-cause hospital readmission rate, compared to the home TH patients with a 10% all-cause readmission rate. Statistical differences were found between groups on the variables of fall risk, vision, smoking, shortness of breath, the ability to bathe and take oral meds, along with having been discharged from a skilled nursing facility in the last 2 weeks. These results indicate that aggregate data analysis is useful in providing insight into program effectiveness. This study suggests TH programs have the potential to reduce the burden associated with rehospitalizations in the heart failure population.

摘要

技术具有改善医疗服务质量的潜力。远程患者监测(即远程医疗,TH)的应用已被许多家庭护理机构广泛采用,以促进疾病恶化的早期识别,特别是对于心力衰竭等慢性病患者。远程医疗已成功用于改善症状检测并可能降低再住院率。通过数据分析量化项目效果是项目改进、资源分配和未来战略规划的关键步骤。利用结果与评估信息集-C数据库,对南加州一家家庭护理机构22个月的心力衰竭患者数据进行了回顾性分析。将70名接受远程医疗的患者与接受常规家庭护理服务的患者进行了比较。两组患者的基线社会人口统计学特征没有重大差异。在接受家庭医疗服务期间,非远程医疗患者的全因住院再入院率为21%,而接受远程医疗的家庭患者的全因再入院率为10%。在跌倒风险、视力、吸烟、呼吸急促、洗澡和口服药物能力以及过去2周内从专业护理机构出院等变量上,两组之间存在统计学差异。这些结果表明,汇总数据分析有助于深入了解项目效果。这项研究表明,远程医疗项目有可能减轻心力衰竭人群再住院带来的负担。

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