医保受益人的急性后期康复后成功社区出院：以患者为中心的质量措施分析。
Successful Community Discharge Following Postacute Rehabilitation for Medicare Beneficiaries: Analysis of a Patient-Centered Quality Measure.
机构信息
Duke University School of Nursing, Durham, NC.
Department of Orthopaedic Surgery, School of Medicine, Duke University, Durham, NC.
出版信息
Health Serv Res. 2018 Aug;53(4):2470-2482. doi: 10.1111/1475-6773.12796. Epub 2017 Nov 13.
Abstract
OBJECTIVE
To determine the sociodemographic and clinical characteristics as well as health services use associated with successful community discharge.
DATA SOURCE
Inpatient Rehabilitation Facility-Patient Assessment Instrument and Medicare Provider Analysis and Review files.
STUDY DESIGN
We retrospectively examined 167,664 Medicare beneficiaries discharged from inpatient rehabilitation facilities (IRFs) in 2013 to determine the sociodemographic and clinical characteristics as well as health services use associated with successful community discharge.
PRINCIPAL FINDINGS
In the multivariable model, sociodemographic (younger age, no disability, social support), clinical (higher motor and cognitive functional status at admission), and health services use (fewer acute care days and longer IRF days) variables were associated with successful community discharge.
CONCLUSIONS
Remaining in the community is an important patient-centered outcome that could complement other postacute rehabilitation quality measures.
摘要
目的
确定与成功社区出院相关的社会人口学和临床特征以及卫生服务利用情况。
资料来源
住院康复设施-患者评估工具和医疗保险提供者分析和审查文件。
研究设计
我们回顾性地检查了 2013 年从住院康复机构 (IRF) 出院的 167664 名医疗保险受益人的资料，以确定与成功社区出院相关的社会人口学和临床特征以及卫生服务利用情况。
主要发现
在多变量模型中，社会人口学（年龄较小、无残疾、社会支持）、临床（入院时运动和认知功能状态较高）和卫生服务利用（急性护理天数较少和 IRF 天数较长）变量与成功社区出院相关。
结论
留在社区是一个重要的以患者为中心的结果，可以补充其他康复后质量措施。
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