Rahman Momotazur, Gadbois Emily A, Tyler Denise A, Mor Vincent
Center for Gerontology and Healthcare Research, Brown University, Providence, RI.
Aging, Disability& Long-Term Care, RTI International, Waltham, MA.
Health Serv Res. 2018 Dec;53(6):4808-4828. doi: 10.1111/1475-6773.13016. Epub 2018 Aug 5.
To characterize the nature and degree of hospitals' efforts to collaborate with skilled nursing facilities (SNFs) and associated patient outcomes.
DATA SOURCES/STUDY SETTING: Qualitative data were collected through 138 interviews with staff in 16 hospitals and 25 SNFs in eight markets across the United States in 2015. Quantitative data include Medicare claims data for the 290,603 patients discharged from those 16 hospitals between 2008 and 2015.
STUDY DESIGN/DATA COLLECTION: Semi-structured interviews with hospital and SNF staff were coded and used to classify hospitals' collaboration efforts with SNFs into high versus low collaboration hospitals, and risk-adjusted, claims-based hospital readmission rates from SNF were compared.
Hospital collaboration efforts were defined as establishing SNF partners, transition management initiatives, and hospital staff visits to SNFs. High collaboration hospitals were more likely to send patients to SNFs (as opposed to home, home with home health, or other PAC settings), sent a higher share of patients to high quality SNFs, and had fewer hospital readmissions from SNF sooner than did low collaboration hospitals.
Although collaboration with SNF requires significant administrative and clinical time investment, it is associated with positive patient outcomes.
描述医院与专业护理机构（SNFs）合作的性质和程度以及相关的患者预后情况。
数据来源/研究背景：2015年，通过对美国八个市场的16家医院和25家SNFs的工作人员进行138次访谈收集了定性数据。定量数据包括2008年至2015年间从这16家医院出院的290,603名患者的医疗保险索赔数据。
研究设计/数据收集：对医院和SNFs工作人员进行的半结构化访谈进行编码，并用于将医院与SNFs的合作努力分为高合作医院和低合作医院，同时比较基于索赔的、经风险调整后的SNFs医院再入院率。
医院的合作努力被定义为建立SNFs合作伙伴、过渡管理举措以及医院工作人员对SNFs的走访。高合作医院更有可能将患者送往SNFs（而非家中、接受家庭健康护理的家中或其他术后急性护理环境），将更高比例的患者送往高质量的SNFs，并且与低合作医院相比，SNFs导致的医院再入院情况更少。
尽管与SNFs合作需要投入大量行政和临床时间，但它与积极的患者预后相关。
