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医疗保险和医疗补助服务中心的报销政策与护理敏感型患者不良结局

The Centers for Medicare & Medicaid Services Reimbursement Policy and Nursing-Sensitive Adverse Patient Outcomes.

作者信息

Bae Sung-Heui

出版信息

Nurs Econ. 2016 Jul-Aug;34(4):161-71, 181.

PMID:29975019
Abstract

The Centers for Medicare & Medicaid Services (CMS) reimbursement policy identified 11 preventable adverse outcomes. Of these 11 patient outcomes, four (severe pressure ulcers, falls and trauma, catheter-associated urinary tract infections, and vascular catheter-associated infections) are considered nursing-sensitive quality outcomes that can be decreased with greater and better nursing care. A cross-sectional study examined the CMS reimbursement policy focusing on nursing-sensitive adverse patient outcomes. The percentage of Medicare patients served as a proxy for a measure of the CMS changes in reimbursement. The CMS reimbursement policy measured by the proxy variable was not related to a reduction of the four adverse outcomes.

摘要

医疗保险和医疗补助服务中心(CMS)的报销政策确定了11种可预防的不良后果。在这11种患者结局中,有4种(严重压疮、跌倒和创伤、导尿管相关尿路感染以及血管导管相关感染)被视为护理敏感质量结局,通过提供更优质的护理可以减少这些情况。一项横断面研究考察了聚焦于护理敏感型不良患者结局的CMS报销政策。医疗保险患者的比例被用作衡量CMS报销变化的一个指标。通过该代理变量衡量的CMS报销政策与这四种不良结局的减少并无关联。

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