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与成功纳入心力衰竭社区辅助医疗项目相关的因素。

Factors Associated With Successful Enrollment in a Community Paramedicine Program for Heart Failure.

作者信息

Johnson Daniel, Druschel Jason, Wattai Brandon, Mann Jessica

机构信息

Department of Emergency Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, USA.

出版信息

Cureus. 2023 Feb 9;15(2):e34811. doi: 10.7759/cureus.34811. eCollection 2023 Feb.

Abstract

Introduction Participation in community paramedicine (CP) programs, sometimes referred to as Mobile Integrated Healthcare (MIH), may improve patient-centered outcomes and reduce hospital readmissions. The objective of this study was to correlate patient and system-specific factors with successful enrollment in a CP program for heart failure.  Methods We conducted a retrospective review of patients enrolled in a CP program after hospitalization for a heart failure-related diagnosis. All patients greater than 18 years of age referred to the CP program with a heart-failure-related diagnosis were included. Factors including age, sex, hospital length of stay, enrollment method, concurrent use of transitional care services, care team, and service line referral were collected. The primary outcome was successful enrollment which led to an initial home visit. Chi-square and t-tests were performed to determine if the outcome differed between cohorts.  Results A total of 908 patients met the inclusion criteria, and 677 (74.7%) received home visits. Increased participation was noted in patients enrolled in person (81.1% vs. 66%, p<0.01) and those also receiving transitional care services (78.9% vs. 62.5%, p<0.01).  Conclusion We conclude that efforts should be made to contact patients in person, prior to hospital discharge, who are eligible for CP services.

摘要

引言 参与社区护理(CP)项目,有时也称为移动综合医疗(MIH),可能会改善以患者为中心的治疗效果并减少医院再入院率。本研究的目的是将患者及系统特定因素与成功纳入心力衰竭CP项目相关联。方法 我们对因心力衰竭相关诊断住院后纳入CP项目的患者进行了回顾性研究。纳入所有年龄大于18岁、因心力衰竭相关诊断被转诊至CP项目的患者。收集的因素包括年龄、性别、住院时间、纳入方式、同时使用过渡性护理服务情况、护理团队及服务线转诊情况。主要结局是成功纳入并导致首次家访。进行卡方检验和t检验以确定不同队列的结局是否存在差异。结果 共有908名患者符合纳入标准,677名(74.7%)接受了家访。亲自纳入的患者(81.1%对66%,p<0.01)以及同时接受过渡性护理服务的患者(78.9%对62.5%,p<0.0)的参与度更高。结论 我们得出结论,应努力在出院前亲自联系符合CP服务条件的患者。

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