Nursing Home Compare Star Rankings and the Variation in Potentially Preventable Emergency Department Visits and Hospital Admissions.
Nursing Home Compare Star Rankings and the Variation in Potentially Preventable Emergency Department Visits and Hospital Admissions.
复制标题
DOI：
10.1089/pop.2018.0065
复制
发表时间：
2019-04
影响因子：
2.5
通讯作者：
McCullough EC
中科院分区：
文献类型：
--
作者：
Fuller RL;Goldfield NI;Hughes JS;McCullough EC
对美国医疗保健质量的衡量越来越强调临床结果而不是临床过程。护理之家比较星星评级是由医疗保险提供，以帮助选择更好的护理之家。作者确定了2年内（2010-2011年）居住在全美12，883家疗养院的439，011名长期疗养院居民的2种重要临床结局（可能可预防的入院和可能可预防的急诊室（艾德）就诊）的发生率和类型，并将其与星星评级系统进行比较。这项研究发现，（1）潜在可预防事件的可能性随着慢性疾病负担的增加而增加，（2）住院和艾德就诊的主要原因（例如，败血症、肺炎、意识模糊、胃肠炎）不是现有养老院质量措施的一部分，（3）疗养院居民的潜在可预防入院率和艾德就诊率在各州之间和各州内部差异很大，其中5个州的这两项指标均超过全国平均水平的20%，以及（4）疗养院比较星级指标与这些潜在可预防事件的发生率相关性有限。护理之家比较星星排名可以受益于纳入结果的措施，如可预防的住院和艾德访问，并通过比较护理之家的表现，从跨州，而不是在他们内部得出的结果。这样的改革可以更好地帮助用户找到更高质量的养老院，并刺激养老院以有利于居民的方式提高质量。
Measurement of the quality of US health care increasingly emphasizes clinical outcomes over clinical processes. Nursing Home Compare Star Ratings are provided by Medicare to help select better nursing home care. The authors determined the rates and types of 2 important clinical outcomes–potentially preventable hospital admissions and potentially preventable emergency department (ED) visits–for a subset of 439,011 long-term nursing homes residents residing in 12,883 nursing homes throughout the United States over a 2-year period (2010–2011) and compared them with the Star Rating system. This study found that (1) the likelihood of potentially preventable events increases with increasing burden of chronic illness, (2) the principle reasons for hospital admissions and ED visits (eg, septicemia, pneumonia, confusion, gastroenteritis) are not part of existing nursing home quality measures, (3) the rate of potentially preventable admissions and ED visits for nursing homes residents varies greatly both across and within states, with 5 states having in excess of 20% more than the national average for both, and (4) the Nursing Home Compare Stars measure has limited correlation with rates of these potentially preventable events. Nursing Home Compare Star rankings could benefit by incorporating outcomes measures such as preventable hospitalizations and ED visits, and by comparing nursing home performance on results drawn from across states rather than within them. Such reform could better help users find nursing homes of higher quality and stimulate homes to improve quality in ways that benefit residents.
登录
查看更多内容
影响因子：
2.5
作者：
Fuller, Richard L.;Hughes, John S.;Goldfield, Norbert I.
通讯作者：
Goldfield, Norbert I.
影响因子：
6.3
作者：
Wang HE;Shah MN;Allman RM;Kilgore M
通讯作者：
Kilgore M
影响因子：
2.3
作者：
Goldfield, Norbert;Averill, Richard;Grant, Thelma
通讯作者：
Grant, Thelma
影响因子：
1.4
作者：
Millwee, Billy;Goldfield, Norbert;Turnipseed, Jeff
通讯作者：
Turnipseed, Jeff
影响因子：
9.7
作者：
McHugh, John P.;Foster, Andrew;Tyler, Denise A.
通讯作者：
Tyler, Denise A.