工具变量分析在儿科临终研究中的应用：案例研究。
Application of Instrumental Variable Analysis in Pediatric End-of-Life Research: A Case Study.
机构信息
College of Nursing, University of Tennessee, Knoxville, TN, USA.
Department of Health Services Research and Administration, University of Nebraska Medical Center, Omaha, NE, USA.
出版信息
West J Nurs Res. 2023 Jun;45(6):571-580. doi: 10.1177/01939459231163441. Epub 2023 Mar 25.
Instrumental variable analysis (IVA) has been widely used in many fields, including health care, to determine the comparative effectiveness of a treatment, intervention, or policy. However, its application in pediatric end-of-life care research has been limited. This article provides a brief overview of IVA and its assumptions. It illustrates the use of IVA by investigating the comparative effectiveness of concurrent versus standard hospice care for reducing 1-day hospice enrollments. Concurrent hospice care is a relatively recent type of care enabled by the Affordable Care Act in 2010 for children enrolled in the Medicaid program and allows for receiving life-prolonging medical treatment concurrently with hospice care. The IVA was conducted using observational data from 18,152 pediatric patients enrolled in hospice between 2011 and 2013. The results indicated that enrollment in concurrent hospice care reduced 1-day enrollment by 19.3%.
工具变量分析（IVA）已被广泛应用于包括医疗保健在内的多个领域，以确定治疗、干预或政策的相对有效性。然而，它在儿科临终关怀研究中的应用受到限制。本文简要介绍了 IVA 及其假设。通过调查同期与标准临终关怀对减少 1 天内入住临终关怀的比较效果，说明了 IVA 的应用。同期临终关怀是一种相对较新的护理方式，由 2010 年平价医疗法案（Affordable Care Act）为参加医疗补助计划（Medicaid program）的儿童提供，允许在接受延长生命的治疗的同时接受临终关怀。IVA 使用了 2011 年至 2013 年期间 18152 名接受临终关怀的儿科患者的观察数据进行。结果表明，同期临终关怀的参与减少了 1 天的参与率 19.3%。
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