PRIMARY-CARE, AVOIDABLE HOSPITALIZATION, AND OUTCOMES OF CARE - A LITERATURE-REVIEW AND METHODOLOGICAL APPROACH
PRIMARY-CARE, AVOIDABLE HOSPITALIZATION, AND OUTCOMES OF CARE - A LITERATURE-REVIEW AND METHODOLOGICAL APPROACH
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DOI：
10.1177/107755879505200106
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发表时间：
1995-03-01
影响因子：
2.5
通讯作者：
FLEMING, ST
中科院分区：
文献类型：
--
作者：
FLEMING, ST
本文的目的是回顾有关初级保健、可能可避免的住院治疗和护理结果之间关系的文献，并开发一种研究这些关系的方法。 该方法包括制定选择医疗状况的标准、汇总门诊和急症护理记录的患者索赔文件以及描述护理事件。 提出了医生就诊的分类法，根据护理类型、疾病类型以及与医院事件的联系对就诊进行分类。 指定了使用和结果的结构模型，其中包括风险率模型，以估计潜在可避免的住院治疗、初级保健和临时医生就诊以及死亡率的可能性；后者建议修改医疗保健融资管理方法，其中包括医生就诊变量。
The purpose of this article is to review the literature on the relationships between primary care, potentially avoidable hospitalizations, and outcomes of care and to develop a methodology to study these relationships. The methodological approach includes developing criteria to select medical conditions, aggregating patient claims files of both ambulatory and acute care records, and delineating episodes of care. A taxonomy of physician visits is proposed that classifies visits on the basis of type of care, type of illness, and linkage to hospital episodes. A structural model of use and outcomes is specified that includes hazard rate models to estimate the likelihood of a potentially avoidable hospitalization, primary care and ad hoc physician visits, and mortality; the latter suggests a modification of the Health Care Financing Administration methodology that includes physician visit variables.