Cognitive impairment associated with greater care intensity during home health care.
Cognitive impairment associated with greater care intensity during home health care.
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DOI：
10.1002/alz.12438
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发表时间：
2022-06
期刊：
影响因子：
--
通讯作者：
Bowles KH
中科院分区：
文献类型：
--
作者：
Burgdorf JG;Amjad H;Bowles KH
在医疗保险资助的家庭医疗保健（HHC）中，三分之一的患者患有认知障碍（CI），但对他们在这种情况下接受的护理强度知之甚少。最近的HHC报销变化未能调整患者CI，可能会对照顾这些人产生财务抑制作用。这项队列研究包括2011-2016年间1，214名Medicare HHC患者的全国代表性样本。多变量逻辑和负二项回归模型患者CI和护理强度之间的关系，测量的数量和类型的访问期间收到的HHC和接收多个连续HHC发作的可能性。CI患者接受多次连续HHC发作的几率高45%（p<0.05），在指数HHC发作期间，共接受2.82次（p<0.001）、1.39次护理（p =0.003）、0.72次物理治疗（p=0.03）和0.60次职业治疗访视（p=0.01）。最近HHC报销的变化并不反映CI患者更需要重症监护。
In Medicare-funded home health care (HHC), 1 in 3 patients has cognitive impairment (CI), but little is known about the care intensity they receive in this setting. Recent HHC reimbursement changes fail to adjust for patient CI, potentially creating a financial disincentive to caring for these individuals. This cohort study included a nationally representative sample of 1,214 Medicare HHC patients between 2011-2016. Multivariable logistic and negative binomial regressions modelled the relationship between patient CI and care intensity—measured as the number and type of visits received during HHC and likelihood of receiving multiple successive HHC episodes. Patients with CI had 45% (p<0.05) greater odds of receiving multiple successive HHC episodes and received an additional 2.82 total (p<0.001), 1.39 nursing (p=0.003), 0.72 physical therapy (p=0.03), and 0.60 occupational therapy visits (p=0.01) during the index HHC episode. Recent HHC reimbursement changes do not reflect the more intensive care needs of patients with CI.
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DOI：
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期刊：
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