Haber Susan G, Wensky Suzanne G, McCall Nancy T
1 RTI International, Waltham, MA, USA.
2 Centers for Medicare & Medicaid Services, Baltimore, MD, USA.
J Aging Health. 2017 Apr;29(3):510-530. doi: 10.1177/0898264316641074. Epub 2016 Jul 9.
To examine the association among nursing home residents between strength of relationship with a primary care provider (PCP) and inpatient hospital and emergency room (ER) utilization.
Medicare administrative data for beneficiaries residing in a nursing home between July 2007 and June 2009 were used in multivariate analyses controlling for beneficiary, nursing home, and market characteristics to assess the association between two measures-percentage of months with a PCP visit and whether the patient maintained the same usual source of care after nursing home admission-and hospital admissions and ER visits for all causes and for ambulatory care sensitive conditions (ACSCs).
Both measures of strength of patient-provider relationships were associated with fewer inpatient admissions and ER visits, except regularity of PCP visits and ACSC ER visits.
Policy makers should consider increasing the strength of nursing home resident and PCP relationships as one strategy for reducing inpatient and ER utilization.
研究疗养院居民与初级保健提供者（PCP）关系的紧密程度与住院和急诊室（ER）利用率之间的关联。
使用2007年7月至2009年6月期间居住在疗养院的受益人的医疗保险管理数据进行多变量分析，控制受益人、疗养院和市场特征，以评估两项指标之间的关联，这两项指标分别是接受PCP诊疗的月数百分比以及患者在入住疗养院后是否维持相同的常规护理来源，同时评估所有病因以及门诊护理敏感疾病（ACSC）的住院和急诊就诊情况。
除了PCP就诊的规律性与ACSC急诊就诊外，患者与提供者关系紧密程度的两项指标均与较少的住院和急诊就诊相关。
政策制定者应考虑增强疗养院居民与PCP之间的关系，以此作为减少住院和急诊利用率的一项策略。
