Assessing the impact of Minnesota's return to community initiative for newly admitted nursing home residents.
Assessing the impact of Minnesota's return to community initiative for newly admitted nursing home residents.
复制标题
评估明尼苏达州重返社区倡议对新入住的疗养院居民的影响。
DOI：
10.1111/1475-6773.13118
复制
发表时间：
2019
影响因子：
3.4
通讯作者：
Arling,Greg
中科院分区：
文献类型：
--
作者：
Hass,Zachary;Woodhouse,Mark;Grabowski,DavidC;Arling,Greg
目的评价明尼苏达州重返社区计划(RTCI)对养老院社区出院的影响。数据来源：二次数据来源于最小数据集和RTCI工作人员(2014年4月至2016年12月)。样本包括明尼苏达州18,444名非医疗补助养老院入院患者，持续时间至少45天，预测社区出院的可能性很高。研究设计RTCI通过协助出院规划、过渡到社区和出院后随访，促进非医疗补助养老院居民的社区出院。一个关键的评估问题是，这些转变中有多少直接归因于该项目。回归社区倡议是在全州范围内实施的，没有设立对照小组。项目影响使用回归不连续性来衡量，这是一种利用项目目标模型的准实验设计方法。主体发现回归社区倡议使目标人群的社区流失率估计增加了11%(P<；0.05)。项目效果随着时间的推移而增强，并随着设施参与RTCI的水平而增加。结论RTCI对其目标人群的社区出院率有适度但显著的影响。研究结果已被应用于加强区域技术合作中心的目标方法和过渡进程。
ObjectiveTo evaluate Minnesota's Return to Community Initiative's (RTCI) impact on community discharges from nursing homes.Data SourcesSecondary data were from the Minimum Data Set and RTCI staff (April 2014 – December 2016). The sample consisted of 18 444 non‐Medicaid nursing home admissions in Minnesota remaining for at least 45 days, with high predicted probability of community discharge.Study DesignThe RTCI facilitates community discharge for non‐Medicaid nursing home residents by assisting with discharge planning, transitioning to the community, and postdischarge follow‐up. A key evaluation question is how many of those transitions were directly attributable to the program. Return to Community Initiative was implemented statewide without a control group. Program impact was measured using regression discontinuity, a quasi‐experimental design approach that leverages the programs targeting model.Principal FindingsReturn to Community Initiative increased community discharge rates by an estimated 11 percent (P< 0.05) for the targeted population. The program effect was robust to time and increased with level of facility participation in RTCI.ConclusionsThe RTCI had a modest yet significant impact on the community discharge rates for its targeted population. Findings have been applied in strengthening the RTCI's targeting approach and transitioning process.