老年痴呆退伍军人的连续性护理与成功出院

Continuity of Care and Successful Hospital Discharge of Older Veterans With Dementia.

作者信息

Lei Lianlian, Cai Shubing, Conwell Yeates, Fortinsky Richard H, Intrator Orna

机构信息

Department of Psychiatry, 1259University of Michigan, Ann Arbor, MI, USA.

VHA Office Geriatrics & Extended Care Data & Analyses Center (GECDAC), Washington, DC, USA.

出版信息

J Appl Gerontol. 2022 Apr;41(4):1035-1046. doi: 10.1177/07334648211051867. Epub 2021 Oct 22.

DOI:10.1177/07334648211051867

PMID:34686087

Abstract

BACKGROUND

Care transitions are frequent among patients with dementia. This study aimed to estimate the impact of continuity of care (COC) on successful community discharge after hospitalization.

METHODS

National Veterans Health Administration data linked to Medicare claims in fiscal years 2014-2015. Community-dwelling older veterans with dementia with an acute hospitalization were included ( = 31,648). COC was measured by the Bice-Boxerman Continuity of Care (BBC) index (0-1). Association of COC before hospitalization on successful community discharge was examined separately among veterans discharged to the community directly and through post-acute care facilities.

RESULTS

Veterans with a 0.1 higher BBC were 4.6% ( = .06) more likely to have successful direct community discharge; but BBC had no demonstrable effect when discharge was through post-acute care facilities.

CONCLUSION

Better COC may have impact at improving successful direct community discharge, although the effect is small and the type I error rate (statistical significance) was 6%.

摘要

背景

痴呆症患者经常经历护理转接。本研究旨在评估护理连续性（COC）对住院后成功社区出院的影响。

方法

利用2014 - 2015财年与医疗保险索赔相关联的国家退伍军人健康管理局数据。纳入患有痴呆症且急性住院的社区居住老年退伍军人（n = 31,648）。护理连续性通过比塞 - 博克斯曼护理连续性（BBC）指数（0 - 1）进行衡量。分别在直接出院至社区和通过急性后护理设施出院的退伍军人中，研究住院前护理连续性与成功社区出院之间的关联。