Program Interruptions and Short-Stay Transfers Represent Potential Targets for Inpatient Rehabilitation Care-Improvement Efforts.
Program Interruptions and Short-Stay Transfers Represent Potential Targets for Inpatient Rehabilitation Care-Improvement Efforts.
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DOI：
10.1097/phm.0000000000000629
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发表时间：
2016-11
影响因子：
3
通讯作者：
Ottenbacher KJ
中科院分区：
文献类型：
--
作者：
Middleton A;Graham JE;Krishnan S;Ottenbacher KJ
对中风、创伤性脑损伤（TBI）和创伤性脊髓损伤（SCI）后接受住院康复治疗的Medicare按服务收费受益人的计划中断和短期转移进行全面的描述性总结。回顾性队列研究的医疗保险受益人与任何三个条件的利益谁承认住院康复直接从急性医院2012年7月1日至2013年11月15日。在最终样本中（中风：n=71 769; TBI：n=7109; SCI：n=659），程序中断率分别为0.9%（中风）、0.8%（TBI）和1.4%（SCI）。短期转移率分别为22.3%（中风）、21.8%（TBI）和31.6%（SCI）。在中风患者中，14.7%的短期转移和12.3%的中断导致恢复急性护理被确定为潜在可预防的，在TBI患者中，10.2%的转移和11.7%的中断，以及在SCI患者中，3.8%的转移和11.1%的中断。目前正在实施旨在提高质量和降低成本的广泛的保健政策。减少住院康复护理过程中的程序中断和短期停留转移是护理改进工作的潜在目标。未来的研究重点是确定潜在不良后果的可改变的风险因素，将允许有针对性的预防干预措施。
To present comprehensive descriptive summaries of program interruptions and short-stay transfers among Medicare fee-for-service beneficiaries receiving inpatient rehabilitation following stroke, traumatic brain injury (TBI), and traumatic spinal cord injury (SCI). Retrospective cohort study of Medicare beneficiaries with any of the three conditions of interest who were admitted to inpatient rehabilitation directly from an acute hospital between July 1, 2012 and November 15, 2013. In the final sample (stroke: n=71 769; TBI: n=7109; SCI: n=659), program interruption rates were 0.9% (stroke), 0.8% (TBI), and 1.4% (SCI). Short-stay transfer rates were 22.3% (stroke), 21.8% (TBI), and 31.6% (SCI). 14.7% of short-stay transfers and 12.3% of interruptions resulting in a return to acute care were identified as potentially preventable among those with stroke, 10.2% of transfers and 11.7% of interruptions among those with TBI, and 3.8% of transfers and 11.1% of interruptions among those with SCI. Broad healthcare policies aimed at improving quality and reducing costs are currently being implemented. Reducing program interruptions and short-stay transfers during inpatient rehabilitative care represents a potential target for care-improvement efforts. Future research focused on identifying modifiable risk factors for potentially undesirable outcomes will allow for targeted preventative interventions.