Restuccia J, Shwartz M, Ash A, Payne S
Health Care Management Program, Boston University School of Management, USA.
Health Aff (Millwood). 1996 Winter;15(4):156-63. doi: 10.1377/hlthaff.15.4.156.
This study tests whether the rate of inappropriate hospital admissions is high in areas with high medical admission rates. Seventy small geographic areas were formed by grouping Massachusetts ZIP codes by similarity of hospital use. Appropriateness of hospital admission was measured both by applying the Appropriateness Evaluation Protocol and by applying physicians' judgment to the medical records of patients age sixty-five and older who were admitted for treatment of a medical condition in 1990-1992. No relationship between hospital admission rate and inappropriate admission rate was found, which calls into question the common assumption that areas with higher hospital use have more inappropriate use of hospital care.
本研究检验了在医疗住院率高的地区，不适当住院率是否也高。通过按医院使用相似性对马萨诸塞州邮政编码进行分组，形成了70个小地理区域。通过应用适当性评估方案以及对1990 - 1992年因医疗状况入院治疗的65岁及以上患者的病历应用医生判断，来衡量住院的适当性。未发现住院率与不适当住院率之间存在关联，这对医院使用量较高的地区存在更多不适当医院护理使用的普遍假设提出了质疑。
