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家庭医疗热点问题:跨专业学生团队家访对医疗系统超高利用率患者再入院率的影响。

Hotspotting in home health: The impact of interprofessional student-team home visits on readmission rates of super-utilizers of the health care system.

机构信息

Anne Belcher Interprofessional Faculty Scholar in Nursing, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

出版信息

J Interprof Care. 2022 Nov-Dec;36(6):839-844. doi: 10.1080/13561820.2021.2019692. Epub 2022 Jan 11.

Abstract

Studies have shown the impact of interprofessional education (IPE) on health professions students' knowledge, skills, and attitudes and, to some extent, its impact on patient and organizational outcomes. This retrospective quasi-experimental study explored the impact of home visits by teams of interprofessional health professions students on the readmission rates of patients recently discharged from the hospital. Patients (20 in the intervention group, 20 in the control group) were in the care of one home health agency during a 7-month period. The patient groups were similar in terms of gender (55% male, 45% female) and age (mean about 73). The model implemented in this study, referred to as hotspotting, is designed to improve patient outcomes, decrease readmissions, and decrease costs. Twelve student participants included two pharmacy, three public health, three occupational therapy, three nursing, and one medical student. Student teams performed 32 total visits. There was a significant difference between the 30-day hospital readmission rate for the intervention group and the 30-day hospital readmission rate for the control group (ᵡ = 4.286, = 1, = .038). While limited by sample size, this study warrants a closer examination of hotspotting in home health as an effective way to improve patient outcomes and decrease costs.

摘要

研究表明,跨专业教育(IPE)对卫生专业学生的知识、技能和态度有影响,在一定程度上对患者和组织的结果也有影响。本回顾性准实验研究探讨了由跨专业卫生专业学生组成的团队进行家访对最近出院的患者再入院率的影响。在 7 个月的时间里,患者(干预组 20 人,对照组 20 人)由一家家庭保健机构负责。两组患者在性别(男性 55%,女性 45%)和年龄(平均约 73 岁)方面相似。本研究中实施的模型,称为热点定位,旨在改善患者的结果,减少再入院,降低成本。12 名学生参与者包括两名药剂师、三名公共卫生专业人员、三名职业治疗师、三名护士和一名医学生。学生团队共进行了 32 次访问。干预组的 30 天内医院再入院率与对照组的 30 天内医院再入院率有显著差异(ᵡ=4.286,=1,=0.038)。虽然受到样本量的限制,但本研究值得进一步研究家庭保健中的热点定位作为改善患者结果和降低成本的有效方法。

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