School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.
University of Washington, WA School of Nursing, Seattle, WA, USA.
J Appl Gerontol. 2023 Jul;42(7):1414-1423. doi: 10.1177/07334648231155444. Epub 2023 Feb 4.
Persons living with dementia (PLWD) are more likely to be hospitalized than individuals without dementia. Little is known about key features (i.e., structural capabilities) in primary care practices where PLWD receive care. This study assessed the relationship between structural capabilities (i.e., care coordination, community integration, and reminder systems) and hospitalizations among PLWD. We conducted a secondary analysis of cross-sectional data from 5001 PLWD in 192 practices and used three datasets: nurse practitioner surveys, Medicare claims, and Minimum Data Set. Using generalized estimating equations, we evaluated the association between structural capabilities and hospitalizations. PLWD who received care from practices with care coordination were less likely to have hospitalizations ( = 0.62, < .05). No statistically significant associations were observed between community integration and reminder systems and hospitalizations. Primary care practices need to tailor structural capabilities to address the needs of PLWD to reduce hospitalizations.
患有痴呆症的人(PLWD)比没有痴呆症的人更有可能住院。对于 PLWD 接受护理的初级保健实践中的关键特征(即结构能力)知之甚少。本研究评估了结构能力(即护理协调、社区整合和提醒系统)与 PLWD 住院之间的关系。我们对来自 192 个实践的 5001 名 PLWD 的横断面数据进行了二次分析,并使用了三个数据集:护士从业者调查、医疗保险索赔和最低数据集。使用广义估计方程,我们评估了结构能力与住院之间的关联。接受具有护理协调的实践护理的 PLWD 住院的可能性较低( = 0.62, <.05)。社区整合和提醒系统与住院之间没有观察到统计学上显著的关联。初级保健实践需要调整结构能力,以满足 PLWD 的需求,从而减少住院治疗。