Personalizing Nursing Home Compare and the Discharge from Hospitals to Nursing Homes
Personalizing Nursing Home Compare and the Discharge from Hospitals to Nursing Homes
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DOI：
10.1111/1475-6773.12588
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发表时间：
2016-12-01
影响因子：
3.4
通讯作者：
Sorkin, Dara H.
中科院分区：
文献类型：
--
作者：
Mukamel, Dana B.;Amin, Alpesh;Sorkin, Dara H.
目标。为了测试个性化成绩单的使用是否比从医院到养老院的常规出院流程带来更好的结果，疗养院比较Plus （NHCPlus）嵌入了一个重新设计的出院流程。数据来源/设置。主要数据收集于2014年3月至2015年8月间在一所大学医学中心的内科和外科。研究设计。一项随机对照试验，干预组患者给予nhc +。参与者包括225名患者或其家属/代理人。数据收集。记录NHCPlus用户的按键，获取使用信息。我们调查了用户对NHCPlus的可用性和满意度。所有参与者在出院时都接受了调查。调查数据与医疗记录合并。主要的发现。大约85%的用户对NHCPlus表示满意。与对照组相比，干预患者对选择过程更满意（40%的标准差p < 0.01），更有可能前往排名较高的五星级养老院（OR = 1.8, p < 0.05），更有可能前往更远的养老院（IRR = 1.27, p < 0.10），住院时间更短（IRR = 0.84, p < 0.05）。与通常的出院流程相比，个性化报告卡和重新设计出院流程可以提高质量并降低成本。
Objective. To test whether use of a personalized report card, Nursing Home Compare Plus (NHCPlus), embedded in a reengineered discharge process, can lead to better outcomes than the usual discharge process from hospitals to nursing homes.Data Sources/Setting. Primary data collected in the Departments of Medicine and Surgery at a University Medical Center between March 2014 and August 2015.Study Design. A randomized controlled trial in which patients in the intervention group were given NHCPlus. Participants included 225 patients or their family members/surrogates.Data Collection. Key strokes of NHCPlus users were recorded to obtain information about usage. Users were surveyed about usability and satisfaction with NHCPlus. All participants were surveyed at discharge from the hospital. Survey data were merged with medical records.Principal Findings. About 85 percent of users indicated satisfaction with NHCPlus. Compared to controls, intervention patients were more satisfied with the choice process (by 40 percent of the standard deviation p < .01), more likely to go to higher ranked five-star nursing homes (OR = 1.8, p < .05), traveled to further nursing homes (IRR = 1.27, p < .10), and had shorter hospital stays (IRR = 0.84, p < .05).Conclusions. Personalizing report cards and reengineering the discharge process may improve quality and may lower costs compared to the usual discharge process.