探讨种族和家庭健康机构质量在延缓阿尔茨海默病和相关痴呆症（ADRD）患者家庭健康服务启动方面的作用。
Examining the role of race and quality of home health agencies in delayed initiation of home health services for individuals with Alzheimer's disease and related dementias (ADRD).
机构信息
Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, School of Medicine, Richmond, Virginia, USA.
Research Department, Sheltering Arms Institute, Richmond, Virginia, USA.
出版信息
Alzheimers Dement. 2023 Sep;19(9):4037-4045. doi: 10.1002/alz.13139. Epub 2023 May 19.
INTRODUCTION
We examined differences in the timeliness of the initiation of home health care by race and the quality of home health agencies (HHA) among patients with Alzheimer's disease and related dementias (ADRD).
METHODS
Medicare claims and home health assessment data were used for the study cohort: individuals aged ≥65 years with ADRD, and discharged from the hospital. Home health latency was defined as patients receiving home health care after 2 days following hospital discharge.
RESULTS
Of 251,887 patients with ADRD, 57% received home health within 2 days following hospital discharge. Black patients were significantly more likely to experience home health latency (odds ratio [OR] = 1.15, 95% confidence interval [CI] = 1.11-1.19) compared to White patients. Home health latency was significantly higher for Black patients in low-rating HHA (OR = 1.29, 95% CI = 1.22-1.37) compared to White patients in high-rating HHA.
DISCUSSION
Black patients are more likely to experience a delay in home health care initiation than White patients.
简介
本研究旨在探讨不同种族的阿尔茨海默病及相关痴呆症（ADRD）患者在家庭医疗保健启动及时性方面的差异，以及家庭医疗保健机构（HHA）的质量。
方法
本研究使用了医疗保险索赔和家庭健康评估数据，研究对象为年龄≥65 岁、患有 ADRD 并从医院出院的患者。家庭健康延迟是指患者在出院后 2 天内接受家庭健康护理。
结果
在 251887 名患有 ADRD 的患者中，57%的患者在出院后 2 天内接受了家庭健康护理。与白人患者相比，黑人患者接受家庭健康护理的延迟时间明显更长（比值比 [OR] = 1.15，95%置信区间 [CI] = 1.11-1.19）。与白人患者在高评级 HHA 中相比，黑人患者在低评级 HHA 中经历家庭健康延迟的可能性更高（OR = 1.29，95%CI = 1.22-1.37）。
讨论
与白人患者相比，黑人患者更有可能延迟接受家庭医疗保健。
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