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在 SNF 中测试再设计的出院计划实施策略。

Testing Re-Engineered Discharge Program Implementation Strategies in SNFs.

机构信息

University of Missouri, Columbia, USA.

University of Wisconsin Milwaukee, USA.

出版信息

Clin Nurs Res. 2021 Jun;30(5):644-653. doi: 10.1177/1054773820982612. Epub 2020 Dec 22.

Abstract

The Re-Engineered Discharge (RED) program, designed for hospitals, is being trialed in skilled nursing facilities (SNFs) with promising results. This paper reports on the quantitative results of a multimethod study testing two different RED program implementation strategies in SNFs. A pretest-posttest design was used to compare utilization outcomes of two different RED implementation strategies (Enhanced and Standard) and overall group differences in four Midwestern SNFs. In the Standard group there were higher odds of being readmitted in the pre-intervention versus post-intervention period. After adjusting coefficients using Poisson regression, in the pre-intervention period the adjusted number of rehospitalizations for the Standard group was 45% higher at 30 days, 50% higher at 60 days ( = .01), and 39% higher at 180 days ( = .001). SNF RED may be a useful program to reduce rehospitalizations after discharge. Benefit of SNF RED is dependent on degree of adoption of the intervention.

摘要

再入院准备计划(RE-Discharge,RED)是为医院设计的,目前正在疗养院进行试点,效果良好。本文报告了一项多方法研究的定量结果,该研究在 4 家中西部疗养院测试了两种不同的 RED 计划实施策略。采用前后测试设计比较了两种不同 RED 实施策略(增强型和标准型)的利用结果以及整个小组在四个疗养院中的差异。在标准组中,与干预后相比,在干预前的再入院率更高。通过泊松回归调整系数后,在干预前,标准组的 30 天再住院率高出 45%,60 天高出 50%( = .01),180 天高出 39%( = .001)。SNF RED 可能是一种减少出院后再入院的有用方案。SNF RED 的获益取决于干预措施的采用程度。

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