Aging, Disability & Long-Term Care Program, RTI International, North Carolina, USA.
Center for Gerontology & Healthcare Research, Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
J Aging Soc Policy. 2020 Mar-Apr;32(2):141-156. doi: 10.1080/08959420.2019.1578607. Epub 2019 Feb 14.
This study aimed to identify the barriers to a timely discharge from short-term care in Veterans Health Administration (VHA) Community Living Centers (CLCs). Ninety-nine interviews were conducted with CLC staff in leadership and direct-care positions in eight varied CLCs. Major themes identified through qualitative analysis as barriers to a timely discharge were a lack of patients' financial resources, low social support, and reluctance of some veterans and staff to view a timely veteran discharge as their goal. Staff also perceived that barriers were much more difficult to overcome in regions where community-based long-term services and supports were limited or nonexistent. Because VHA has lagged behind Medicaid more generally in terms of investment in these types of services, additional strategies are warranted to achieve the important policy goal of deinstitutionalizing VHA care and returning veterans to their homes in the community.
本研究旨在确定退伍军人健康管理局（VHA）社区生活中心（CLC）中短期护理及时出院的障碍。对八个不同 CLC 中领导和直接护理岗位的 CLC 工作人员进行了 99 次访谈。通过定性分析确定的主要障碍包括患者缺乏经济资源、社会支持低，以及一些退伍军人和工作人员不愿意将退伍军人及时出院作为目标。工作人员还认为，在社区长期服务和支持有限或不存在的地区，这些障碍更难克服。由于 VHA 在这些类型的服务投资方面落后于医疗补助计划，因此需要采取更多策略来实现将 VHA 护理机构化并将退伍军人送回社区的重要政策目标。
