The effects of public reporting on physical restraints and antipsychotic use in nursing home residents with severe cognitive impairment.
The effects of public reporting on physical restraints and antipsychotic use in nursing home residents with severe cognitive impairment.
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公众报告对严重认知障碍的疗养院居民的身体限制和抗精神病药物的影响。
DOI：
10.1111/jgs.12711
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发表时间：
2014-03
影响因子：
6.3
通讯作者：
Werner RM
中科院分区：
文献类型：
--
作者：
Konetzka RT;Brauner DJ;Shega J;Werner RM
旨在评估与质量报告相关的身体约束使用的减少是否可能会导致患有严重认知障碍的疗养院（NH）居民增加抗精神病药物的使用而产生意想不到的后果。对 1999 年至 2008 年 NH 临床评估数据进行回顾性分析，将公开报告身体约束的 NH 与未报告的 NH 进行比较。美国医疗保险和医疗补助认证的 NH。对六个州 4,258 个 NH 中 809,645 名患有严重认知障碍的居民进行的观察（N = 390 万）。公开报告身体约束的使用率。使用身体约束和抗精神病药物。从 1999 年到 2008 年，患有严重认知障碍的新罕布什尔州居民的身体约束使用量显着下降。接受限制报告的 NH 下降幅度大于未报告限制的 NH（–8.3 个百分点与 –3.3 个百分点，P < .001）。相应地，在接受公开报告的 NH 中，相同居民的抗精神病药物使用量增加更多（4.5 个百分点与 2.9 个百分点，P < .001）。大约 36% 的抗精神病药物使用增加可能归因于公开报道的身体约束。该分析表明，公开报告身体约束的使用会产生意想不到的后果，即患有严重认知障碍的新罕布什尔州居民越来越多地使用抗精神病药物。
To assess whether reductions in physical restraint use associated with quality reporting may have had the unintended consequence of increasing antipsychotic use in nursing home (NH) residents with severe cognitive impairment. Retrospective analysis of NH clinical assessment data from 1999 to 2008 comparing NHs subject to public reporting of physical restraints with nonreporting NHs. Medicare-and Medicaid-certified NHs in the United States. Observations (N = 3.9 million) on 809,645 residents with severe cognitive impairment in 4,258 NHs in six states. Public reporting of physical restraint use rates. Use of physical restraints and antipsychotic medications. Physical restraint use declined significantly from 1999 to 2008 in NH residents with severe cognitive impairment. The decline was larger in NHs that were subject to reporting of restraints than in those that were not (–8.3 vs –3.3 percentage points, P < .001). Correspondingly, antipsychotic use in the same residents increased more in NHs that were subject to public reporting (4.5 vs 2.9 percentage points, P < .001). Approximately 36% of the increase in antipsychotic use may be attributable to public reporting of physical restraints. This analysis suggests that public reporting of physical restraint use had the unintended consequence of increasing use of antipsychotics in NH residents with severe cognitive impairment.
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影响因子：
2.9
作者：
Gustafsson, Maria;Karlsson, Stig;Lovheim, Hugo
通讯作者：
Lovheim, Hugo
影响因子：
14
作者：
Desai, Vibha C. A.;Heaton, Pamela C.;Kelton, Christina M. L.
通讯作者：
Kelton, Christina M. L.
影响因子：
3
作者：
Castle, NG
通讯作者：
Castle, NG
影响因子：
120.7
作者：
Koepke, Sascha;Muehlhauser, Ingrid;Meyer, Gabriele
通讯作者：
Meyer, Gabriele
DOI：
10.1111/j.1530-9134.2012.00341.x
发表时间：
2012-09-01
影响因子：
1.9
作者：
Lu, Susan Feng
通讯作者：
Lu, Susan Feng