Healthcare utilization of nursing home residents: Comparison between decedents and survivors
Healthcare utilization of nursing home residents: Comparison between decedents and survivors
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DOI：
10.1111/j.1532-5415.2005.00489.x
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发表时间：
2005-12-01
影响因子：
6.3
通讯作者：
Hebel, JR
中科院分区：
文献类型：
--
作者：
Bercovitz, A;Gruber-Baldini, AL;Hebel, JR
目的：为了确定居民谁死，而在养老院有更高的医疗保健利用率比幸存者和是否在死亡前的时期的利用率随住院时间长短在nursinghome.Design：描述性，纵向研究比较医疗服务使用的居民谁在研究期间死亡的居民谁仍然活着的facility.SETTING：59家疗养院在马里兰州。资料收集于1992年至1995年。对象：随机抽取1,195名居民。测量：住院率，急诊就诊率，总的医疗就诊率，入院后30天和随后90天的间隔。在2年研究期间死亡的居民对所有类型的卫生保健的平均利用率显著高于未从养老院出院的居民，即使在控制痴呆诊断、年龄、功能状态和共病状况的数量时。那些谁死在一个月内入院有显着更多的急诊科和医疗访问比那些谁死后较长stay.CONCLUSION：死亡前的高医疗保健利用率的模式是一致的研究，显示在死亡前的一段时间内增加医疗保险支出的整体医疗保险人口。
OBJECTIVES: To determine whether residents who die while in the nursing home have higher healthcare utilization than survivors and whether the utilization in the periods before death varies with length of stay in the nursing home.DESIGN: Descriptive, longitudinal study comparing medical service use of residents who died during the study period with that of residents who remained alive in the facility.SETTING: Fifty-nine nursing homes in Maryland. Data were collected between 1992 and 1995.PARTICIPANTS: A random sample of 1,195 residents.MEASUREMENTS: Rates of hospitalization, emergency department visits, and medical visits in aggregate and in an initial 30-day and subsequent 90-day intervals after admission to the nursing home.RESULTS: Residents who died during the 2-year study period had significantly greater mean rates of utilization of all types of health care than residents who were not discharged from the nursing home, even when controlling for dementia diagnosis, age, functional status, and number of comorbid conditions. Those who died within a month of admission had significantly more emergency department and medical visits than those who died after a longer stay.CONCLUSION: The pattern of high healthcare utilization before death is consistent with studies of the overall Medicare population that show an increase in Medicare expenditures in the period before death.