Wang Yun, Pandolfi Michelle M, Fine Jonathan, Metersky Mark L, Wang Changqin, Ho Shih-Yieh, Galusha Deron, Nuti Sudhakar V, Murugiah Karthik, Spenard Ann, Elwell Timothy, Krumholz Harlan M
Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, United States of America.
Qualidigm, Wethersfield, Connecticut, United States of America.
Home Health Care Manag Pract. 2016 Nov;28(4):201-208. doi: 10.1177/1084822316639032. Epub 2016 Apr 7.
We evaluated whether community-level home health agencies and nursing home performance is associated with community-level hospital 30-day all-cause risk-standardized readmission rates for Medicare patients used data from the Centers for Medicare & Medicaid Service from 2010 to 2012. Our final sample included 2,855 communities that covered 4,140 hospitals with 6,751,713 patients, 13,060 nursing homes with 1,250,648 residents, and 7,613 home health agencies providing services to 35,660 zipcodes. Based on a mixed effect model, we found that increasing nursing home performance by one star for all of its 4 measures and home health performance by 10 points for all of its 6 measures is associated with decreases of 0.25% (95% CI 0.17-0.34) and 0.60% (95% CI 0.33-0.83), respectively, in community-level risk-standardized readmission rates.
我们利用2010年至2012年医疗保险和医疗补助服务中心的数据，评估了社区层面的家庭健康机构和养老院的绩效是否与医疗保险患者的社区层面医院30天全因风险标准化再入院率相关。我们的最终样本包括2855个社区，覆盖4140家医院的6751713名患者、13060家养老院的1250648名居民，以及7613家为35660个邮政编码区域提供服务的家庭健康机构。基于混合效应模型，我们发现，养老院的4项指标每项提高一星，家庭健康机构的6项指标每项提高10分，分别会使社区层面风险标准化再入院率降低0.25%（95%置信区间0.17 - 0.34）和0.60%（95%置信区间0.33 - 0.83）。
