Postacute rehabilitation care for hip fracture: who gets the most care?
Postacute rehabilitation care for hip fracture: who gets the most care?
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DOI：
10.1111/j.1532-5415.2012.04149.x
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发表时间：
2012-10
影响因子：
6.3
通讯作者：
Ku LJ
中科院分区：
文献类型：
--
作者：
Freburger JK;Holmes GM;Ku LJ
确定髋部骨折后急性康复护理（PARC）使用的人口统计学和地理差异的程度。对两年（2005-2006年）以人口为基础的医院出院数据进行横断面分析。在四个人口和地理上不同的州（AZ， FL， NJ， WI）的所有短期急性护理医院。65岁及以上（平均年龄82.9岁）因髋部骨折入院并在住院期间存活的个体（N=64,065）。样本中女性占75.1%，白人占91.5%，西班牙裔占5.8%，黑人占2.7%。1)受试者是否获得机构PARC；2)未接受机构护理的受试者是否接受家庭健康护理（HH）；3)接受机构护理的受试者，是否接受熟练护理设施（SNF）或住院康复设施（IRF）护理。进行了多水平逻辑回归分析，以确定PARC使用的人口统计学和地理差异。考虑到PARC每天的护理时间从多到少（IRF→SNF→HH→无HH），我们发现少数民族和社会经济地位较低的个体（SES）通常接受较少的护理量。接受医疗补助或未投保的个体接受机构护理（or =0.23 [95% CI: 0.18-0.30]）和接受HH （or =0.46[0.30-0.70]）的可能性较小，而接受SNF与IRF护理的可能性较大（or =2.03[1.36-3.05]）。西班牙裔接受机构护理的可能性较低（OR=0.70 [0.62-0.79]）；西班牙裔和黑人更有可能接受SNF治疗而非IRF治疗（or分别为1.31和1.49）。PARC的地理差异也存在。确定了PARC使用的几个人口和地理差异。未来的研究应证实这些发现，并进一步阐明导致观察到的差异的因素。
To determine the extent to which demographic and geographic disparities exist in post-acute rehabilitation care (PARC) use following hip fracture. Cross-sectional analysis of two years (2005–2006) of population-based, hospital discharge data. All short-term acute care hospitals in four demographically and geographically diverse states (AZ, FL, NJ, WI). Individuals 65 years and older (mean age of 82.9 years) admitted to the hospital with a hip fracture and who survived their inpatient stay (N=64,065). The sample was 75.1 percent female, 91.5 percent White, 5.8 percent Hispanic, and 2.7 percent Black. 1) whether the subject received institutional PARC; 2) for subjects who did not receive institutional care, whether they received home health (HH) care; and 3) for subjects who received institutional care, whether they received skilled nursing facility (SNF) or inpatient rehabilitation facility (IRF) care. Multilevel logistic regression analyses were conducted to identify demographic and geographic disparities in PARC use. Considering PARC on a continuum from more to less hours of care per day (IRF→SNF→HH→no HH), we found that minorities and individuals of lower socioeconomic status (SES) generally received a lower volume of care. Individuals on Medicaid or who were uninsured were less likely to receive institutional care (OR=0.23 [95% CI: 0.18–0.30]) and to receive HH (OR=0.46 [0.30–0.70]) and more likely to receive SNF versus IRF care (OR=2.03 [1.36–3.05]). Hispanics were less likely to receive institutional care (OR=0.70 [0.62–0.79]); and Hispanics and Blacks were more likely to receive SNF versus IRF care (ORs of 1.31 and 1.49 respectively). Geographic differences in PARC were also present. Several demographic and geographic disparities in PARC use were identified. Future research should confirm these findings and further elucidate factors that contribute to the observed disparities.
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影响因子：
4.3
作者：
Nguyen-Oghalai, Tracy U.;Ottenbacher, Kenneth J.;Kuo, Yong-fang;Wu, Helen;Grecula, Michael;Eschbach, Karl;Goodwin, James S.
通讯作者：
Goodwin, James S.
影响因子：
1.9
作者：
Larsen, K;Petersen, JH;Endahl, L
通讯作者：
Endahl, L
影响因子：
3
作者：
Elixhauser, A;Steiner, C;Coffey, RN
通讯作者：
Coffey, RN
影响因子：
2.6
作者：
Barone, Anna Patrizia;Fusco, Danilo;Perucci, Carlo Alberto
通讯作者：
Perucci, Carlo Alberto
影响因子：
4.2
作者：
Sterling, Robert S.
通讯作者：
Sterling, Robert S.