READMISSIONS: AN ANALYSIS OF PRO DATA

重新入院：专业数据分析

• 批准号: 2236611
• 负责人: ROBERT L LUDKE
• 金额: $ 14.4万
• 依托单位: XAVIER UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-09-01 至 1995-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2236611
• 关键词: health care quality; health care service evaluation; hospital analysis; hospital length of stay; hospital utilization; human data; medical records; patient care management

This study will examine the relationship between hospital readmissions within 31 days of a prior hospital discharge and the occurrence of peer review organization (PRO) quality of care screens. Specifically, the study will test several hypotheses to: (1) assess whether patients with a subsequent readmission within 31 days of prior hospital discharge have higher levels of occurrence of the PRO quality screens than patients without a subsequent readmission; (2) examine the relationship between a readmission and the occurrence of the PRO quality screens during the index hospitalization by type of readmission; (3) examine the relationship between the occurrence of the PRO quality screens during the index hospitalization and the length of time between discharge from the index hospitalization and the readmission; and, (4) determine the accuracy of a readmission as a quality of care indicator to potential misclassification errors in the PRO quality screen data. The hypotheses will be tested using existing medical record review data from the Iowa Foundation for medical Care (IFMC), Iowa's peer review organization. For the period April l, 1991 - March 31, 1992, the IFMC reviewed 3,606 Medicare medical/surgical readmissions and 10,689 Medicare hospitalizations without subsequent readmissions. Both descriptive and inferential statistics will be used in the analysis of the data. Statistical tests will use methods for analysis of binary data in which the independent variables are either categorical or continuous. Where appropriate, the results will be reported in-terms of odds ratios as well as significance tests. The effect of potential errors in the PRO data will be assessed by simulating different error rates. This study builds on the program of research that has been undertaken by the project investigators to enhance understanding of hospital readmissions. This research has raised a number of questions regarding the use of a readmission as a measure of the quality of care provided during the preceding hospitalization. By conducting a series of analyses using available PRO data to examine the relationship between a readmission and the occurrence of the PRO quality of care screens, the proposed study will take a first step towards understanding the assumed relationships underlying the PRO readmission review mandate; i.e., that there is a relationship between a readmission and quality of care and that the PRO screens are valid and reliable measures of the quality of inpatient care.

本研究将探讨再入院率之间的关系 在先前出院后31天内， 审查组织（PRO）护理质量屏幕。 具体而言是 研究将测试几个假设：（1）评估患者是否患有 出院后31天内再次入院， PRO质量筛选的发生率高于患者 （2）没有后续再入院;（3）检查 再入院和PRO质量屏幕的发生 按再入院类型列出的指数住院;（3）检查 期间发生PRO质量屏幕之间的关系 指数住院和出院之间的时间长度 指数住院和再入院;和，（4）确定 再入院作为潜在护理质量指标的准确性 PRO质量屏幕数据中的错误分类错误。 的假设 将使用来自爱荷华州的现有病历审查数据进行测试 爱荷华州的同行评审组织医疗保健基金会（IFMC）。为 在1991年4月1日至1992年3月31日期间，IFMC审查了3，606个 医疗保险医疗/手术再入院和10，689医疗保险 没有后续再入院的住院。 既有描述性的， 在数据分析中将使用推论统计。 统计检验将使用二进制数据分析方法， 自变量是分类变量或连续变量。 哪里 适当时，也将以比值比报告结果 作为显著性检验。 PRO数据中潜在错误的影响 将通过模拟不同的错误率进行评估。 这项研究建立了 关于该项目所进行的研究计划， 研究人员加强对医院再入院的了解。 这 研究提出了一些关于使用 再入院率作为衡量医疗期间提供的护理质量的一个指标， 住院前。 通过一系列的分析， 可用的PRO数据，以检查再入院与 发生PRO护理质量筛查，拟定研究 将迈出理解假设关系的第一步 支持PRO再入院审查任务;即，有一个 再入院和护理质量之间的关系，PRO 筛查是衡量住院病人护理质量的有效和可靠措施。