Mortality and Postdischarge Acute Care Utilization for Cardiovascular Conditions at Safety-Net Versus Non-Safety-Net Hospitals.
Mortality and Postdischarge Acute Care Utilization for Cardiovascular Conditions at Safety-Net Versus Non-Safety-Net Hospitals.
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DOI：
10.1016/j.jacc.2021.10.006
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发表时间：
2022-01-04
影响因子：
24
通讯作者：
Wadhera RK
中科院分区：
文献类型：
--
作者：
Liu M;Figueroa JF;Song Y;Wadhera RK
美国医疗保健系统为任何患者提供基本护理，无论保险范围、支付能力或移民身份如何。因此，这些网站过多地照顾病情复杂且社会弱势的患者，同时运营的财务利润却较低。 SNH 也往往是少数种族和族裔社区以及边缘化人群的主要护理场所 (1)。较早的研究一致表明，SNH 在心血管疾病的各种过程和结果指标上（包括 30 天死亡率和再入院率）比非 SNH 表现较差 (2, 3)。然而，在过去的十年中，联邦政策举措，例如根据《平价医疗法案》(ACA) 实施的医院再入院减少计划 (HRRP) 和医院基于价值的采购计划，更加注重改善住院护理，鉴于相对较大的改进空间，这可能促进了 SNH 更好的护理质量。另外，由于其中一些举措对资源本已有限的 SNH 造成了不成比例的惩罚，它们可能无意中阻碍了改善护理的努力 (4)。
US health care system and provide essential care to any patient, regardless of insurance coverage, ability to pay, or immigration status. As a result, these sites disproportionately care for medically complex and socially vulnerable patients while operating on thinner financial margins. SNHs also tend to be primary sites of care for racial and ethnic minority communities, as well as marginalized populations (1).Older studies have consistently demonstrated that SNHs perform worse than non-SNHs on a wide range of process and outcome measures for cardiovascular conditions, including 30-day mortality and readmission rates (2, 3). However, over the past decade, federal policy initiatives such as the Hospital Readmissions Reduction Program (HRRP) and the Hospital Value-Based Purchasing Program implemented under the Affordable Care Act (ACA) have intensified focus on improving inpatient care, which may have promoted better care quality at SNHs, given relatively greater room for improvement. Alternatively, because some of these initiatives have disproportionately penalized already resource-constrained SNHs, they may have unintentionally impeded efforts to improve care (4).
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影响因子：
9.7
作者：
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39.2
作者：
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