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养老院中可预防的门诊护理敏感条件下的住院治疗:来自瑞士的证据。

Preventable hospitalizations from ambulatory care sensitive conditions in nursing homes: evidence from Switzerland.

机构信息

Department of Social and Behavioural Sciences, University of California San Francisco, School of Nursing, San Francisco, USA.

Department of Public Health, Institute of Nursing Science, Faculty of Medicine, University of Basel, Bernoullistr. 28, 4056, Basel, Switzerland.

出版信息

Int J Public Health. 2019 Dec;64(9):1273-1281. doi: 10.1007/s00038-019-01294-1. Epub 2019 Sep 3.

Abstract

OBJECTIVES

Reducing nursing home hospitalizations for ambulatory care sensitive conditions (ACSC) has been identified as an opportunity to improve patient well-being and reduce costs. The aim of this study was to identify number of hospitalizations for ACSCs for nursing home residents in a Swiss national sample, examine demographic characteristics of nursing home hospitalizations due to ACSCs, and calculate hospital expenses from these hospitalizations.

METHODS

Using merged hospital administrative data with payment data based on diagnosis-related groups (DRGs) for the year 2013, we descriptively examined nursing home residents who were 65 years of age or older and were admitted to an acute care hospital.

RESULTS

Approximately 42% of all nursing home admissions were due to ACSCs. Payments to Swiss hospitals for ACSCs can be estimated at between 89 and 105 million Swiss francs in 2013.

CONCLUSIONS

A sizable share of hospitalizations for nursing home residents is for ACSCs, and the associated costs are substantial. Programs and policies designed to reduce these potentially avoidable hospitalizations from the nursing home setting could lead to an increased patient well-being and lower costs.

摘要

目的

减少可在门诊治疗的慢性病造成的疗养院住院(ACSC)已被确定为改善患者福祉和降低成本的机会。本研究的目的是确定瑞士全国样本中疗养院居民因 ACSC 而住院的人数,检查因 ACSC 而导致疗养院住院的人口统计学特征,并计算这些住院的住院费用。

方法

使用 2013 年合并的医院行政数据和基于诊断相关组(DRGs)的支付数据,我们对 65 岁或以上且被收治到急性护理医院的疗养院居民进行了描述性检查。

结果

大约 42%的疗养院入院是由于 ACSC。2013 年,瑞士医院因 ACSC 支付的费用估计在 8900 万至 1.05 亿瑞士法郎之间。

结论

疗养院居民住院的很大一部分是 ACSC,相关费用很高。旨在减少疗养院中这些潜在可避免的住院治疗的计划和政策可能会提高患者的幸福感并降低成本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41aa/6867979/c00f7bc99d6a/38_2019_1294_Fig1_HTML.jpg

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