Continuous monitoring of emergency admissions of older care home residents to hospital
Continuous monitoring of emergency admissions of older care home residents to hospital
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DOI：
10.1093/ageing/afv158
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发表时间：
2016-01-01
期刊：
影响因子：
6.7
通讯作者：
Bardsley, Martin
中科院分区：
文献类型：
--
作者：
Sherlaw-Johnson, Chris;Smith, Paul;Bardsley, Martin
背景：来自检查方案的证据表明，个别养老院为老年人提供的护理质量参差不齐。除了定期检查之外，常规收集的可用于监测质量的信息有限。目的：描述一种使用住院老年人的常规医院数据作为监测疗养院护理质量的手段的方法。方法：我们使用邮政编码匹配将住院人数与疗养院联系起来，并将住院数据作为时间序列进行分析，使用累积和(CUSUM)技术来检测异常高的住院率。结果：如果我们开发CUSUM，使其错误地发出高住院率的次数限制在每年0.1%，那么成功检测到两年内入院率翻一番的几率将从较小家庭的48%到较大家庭的96%不等。结论：使用住院数据的监测工具是可能和可行的，尤其是对较大的房子来说。然而，由于数据的限制，用户需要注意他们如何解释触发器，从而确保后续是适当的。如果疗养院使用自己的信息进行地方监测，使用常规国家数据造成的一些问题可以克服。
Background: evidence from inspection programmes suggest that the quality of care provided by individual care homes for older people is very variable. Aside from periodic inspection, there is limited information that is routinely collected and can be used to monitor quality.Objectives: to describe a method for using routine hospital data on admissions of older people as means for monitoring quality of care within a care home. To explore how this might be applied and used.Methods: we linked hospital admissions to care homes using postcode matching and analysed hospital admission data as a time series, using the Cumulative Sum (CUSUM) technique to detect unusually high rates of admission.Results: if we develop the CUSUM so that the number of times it falsely signals a high rate of admissions is limited to a rate of 0.1% per year, the chances of successfully detecting a doubling of the admission rate within 2 years will range from 48% for the smaller homes to 96% for the larger homes.Conclusion: monitoring tools using data on admissions to hospital are both possible and feasible, particularly for the larger homes. However, due to data limitations, users need to be careful about how they interpret triggers and thus ensure follow-up is appropriate. Some of the problems caused by using routine national data can be overcome if care homes used their own information for local monitoring.