Prevalence, Geographic Variation, and Trends in Hospital Services Relevant to the Care of Older Adults Development of the Senior Care Services Scale and Examination of Measurement Properties
Prevalence, Geographic Variation, and Trends in Hospital Services Relevant to the Care of Older Adults Development of the Senior Care Services Scale and Examination of Measurement Properties
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DOI：
10.1097/mlr.0000000000000408
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发表时间：
2015-09-01
期刊：
影响因子：
3
通讯作者：
Leff, Bruce
中科院分区：
文献类型：
--
作者：
Arbaje, Alicia I.;Yu, Qilu;Leff, Bruce
目的：通过(1)确定与老年人护理相关的医院服务；(2)对这些服务进行分类；(3)描述美国医院提供的服务随时间的流行、地理变化和趋势。设计、环境和参与者：1999年和2006年美国医院协会年度医院调查(n=4998和4831家医院)中对美国医院的一项回顾队列研究。探索性因素分析被用来建立SCSS，验证性因素分析被用来检查服务随时间的变化。结果：SCSS由2个服务类别组成：(1)住院专科护理(IP)：老年科、姑息治疗、精神科、疼痛管理、社会工作、病例管理、康复和临终关怀；(2)急性后社区护理(PA)：熟练护理、中级护理、其他长期护理、辅助生活、退休住房、成人日间护理和家庭卫生服务。随着时间的推移，医院提供了更多的IP服务和更少的PA服务。服务的分布没有反映美国老年人的分布。结论：SCSS的发展提供了关于《平价医疗法案》通过之前的老年护理服务的重要信息。医院服务和人口趋势的明显不匹配表明，许多美国医院可能无法为日益增长的老年人口提供无缝连续的护理。
Background:The availability of hospital services for older adults nationwide is not well understood.Objective:To present the development of the Senior Care Services Scale (SCSS) through: (1) identification of hospital services relevant to the care of older adults; (2) development of a taxonomy classifying these services; and (3) description of prevalence, geographic variation, and trends in service provision in US hospitals over time.Design, Setting, and Participants:A retrospective cohort study of US hospitals in 1999 and 2006 rounds of American Hospital Association Annual Survey of Hospitals (n=4998 and 4831 hospitals, respectively). Exploratory factor analysis was used to create the SCSS, and confirmatory factor analysis was used to examine services over time. The paper reports prevalence of services nationwide.Results:The SCSS consisted of 2 service groups: (1) Inpatient Specialty Care (IP): geriatrics, palliative care, psychiatric geriatrics, pain management, social work, case management, rehabilitation, and hospice; and (2) Postacute Community Care (PA): skilled nursing, intermediate care, other long-term care, assisted living, retirement housing, adult day care, and home health services. Over time, hospitals offered more IP services and fewer PA services. The distribution of services did not mirror the distribution of where older adults reside in the United States.Conclusions:The development of the SCSS provides important information about senior care services before the passage of the Affordable Care Act. The apparent mismatch of hospital services and demographic trends suggests that many US hospitals may not provide a seamless continuum of care for an increasing population of older adults.