Home health quality in Puerto Rico compared with US states.
Home health quality in Puerto Rico compared with US states.
复制标题
波多黎各的家庭健康质量与美国各州相比。
DOI：
10.1111/jgs.18064
复制
发表时间：
2023
影响因子：
6.3
通讯作者：
Rivera-Hernandez,Maricruz
中科院分区：
文献类型：
--
作者：
Dixit,MeehirN;Rivera-Hernandez,Maricruz
方法我们使用了2015年至2022年可公开获得的CMS HH全国数据和各州数据以及2022年第二季度联邦医疗保险服务提供商文件。关注的三个主要质量指标是HH团队在及时护理时开始患者护理的频率；HH患者必须入院的频率；以及HH患者在未经入院的情况下需要在急诊室进行紧急、计划外护理的频率。我们还提供了卫生保健机构特征的州级描述性数据，包括所有权(营利性与非营利性)、从属关系(医院与非医院)、CMS项目登记人数以及机构规模(单一分支机构与多个分支机构)。结果我们对卫生保健机构特征的分析包括五个州和PR内6,212家独特的卫生保健机构。在公关的66个卫生保健机构中，42个(63.6%)是非营利性的，57个(86.4%)只参加医疗保险，这两个比例都与其他州有显著差异(表1)。总体而言，与除新泽西州外的其他州相比，PR州及时获得HHC的机会排名较低。然而，在观察入院率和急诊室紧急护理就诊时，PR的表现与大多数州相似或略好于大多数州(图1)。
MethodsWe used publicly available CMS HH National Data and State by State Data from 2015 to 2022 and the 2022 Q2 Medicare Provider of Services file. The three primary quality metrics of interest were how often the HH team began their patient’s care in a timely care; how often HH patients had to be admitted to the hospital; and how often HH patients needed urgent, unplanned care in the ER without being admitted. We also provided state-level descriptive data of the characteristics of HH agencies, including ownership (profit vs. non-profit), affiliation (hospital vs. non-hospital based), CMS program enrollment, and agency size (single vs. multiple branches).ResultsOur analysis of HH Agency characteristics included 6,212 unique HH providers within the five states and PR. Of the 66 HH agencies in PR, 42 (63.6%) are non-profit and 57 (86.4%) participate in Medicare only, and both proportions are significantly different from the other states (Table 1). Overall, timely access to HHC in PR ranked low compared to other states, except for New Jersey. However, PR performed similarly or slightly better than most states when looking at hospital admission rate and urgent care visits to the ER (Figure 1).