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国家合作改善熟练护理设施居民的痴呆症护理和医院再入院情况。

The National Partnership to Improve Dementia Care and Hospital Readmission Among Skilled Nursing Facility Residents.

机构信息

Department of Public Health Sciences, 123964University of Chicago Biological Sciences Division, Chicago, IL, USA.

Department of Public Health Sciences, 12299University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.

出版信息

J Appl Gerontol. 2022 Oct;41(10):2148-2156. doi: 10.1177/07334648221102402. Epub 2022 Jun 2.

Abstract

The National Partnership to Improve Dementia Care in Nursing Homes (i.e., the National Partnership) was launched in March 2012. Using national Medicare, Minimum Data Set, and Nursing Home Compare data in CY 2010-2014, we examined changes in hospital readmissions for older post-acute skilled nursing facility (SNF) residents with Alzheimer's disease or related dementias (ADRD) following the National Partnership. Using residents without ADRD as reference group to control for concurrent policy and SNF quality changes, we estimated linear probability models to examine the relationship between readmissions and the National Partnership for residents with ADRD, and also stratified the analysis by quality of SNFs. We found a decreasing trend in hospital readmissions over time. The risk of readmissions in residents with ADRD decreased additional 0.3 percentage-point (p < .01) after the launch of the National Partnership. This relationship varied across SNFs with different quality, as it was stronger in high-quality compared to low-quality SNFs.

摘要

国家改善疗养院痴呆症护理伙伴关系(即国家伙伴关系)于 2012 年 3 月启动。利用 2010 年至 2014 年全国医疗保险、最低数据集和疗养院比较数据,我们研究了在国家伙伴关系之后,患有阿尔茨海默病或相关痴呆症(ADRD)的老年急性后期熟练护理设施(SNF)居民的住院再入院率的变化。我们将没有 ADRD 的居民作为参考组,以控制同期政策和 SNF 质量变化,使用线性概率模型来检验 ADRD 居民的再入院率与国家伙伴关系之间的关系,并按 SNF 的质量对分析进行分层。我们发现随着时间的推移,住院再入院率呈下降趋势。ADRD 居民的再入院风险在国家伙伴关系启动后又降低了 0.3 个百分点(p<.01)。这种关系因 SNF 质量的不同而有所不同,因为在高质量 SNF 中比在低质量 SNF 中更强。

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