Outcomes of Age-Friendly Health Systems: Return to Clinic After 4Ms Care Delivery.

IF 1.7 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES
Grace Q Armstrong, Heba M Aldossary, Jessica Bingham, Lilia Pino, Anne Pohnert, Mary A Dolansky, Nicholas K Schiltz
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Abstract

The Age-Friendly Health System (AFHS) movement continues to grow in the United States as more health systems implement the 4Ms framework. Despite this growth, there are relatively few studies that evaluate outcomes related to AFHS implementation. This study assessed patient satisfaction with AFHS by analyzing the rate at which patients returned to the clinic for future health care, serving as a measure of quality. A retrospective cohort design using electronic health record (EHR) data obtained from patients 65 years of age and older who received care at a large national network of convenient care clinics in the U.S. (N = 987,197) between January 2021 and March 2024. We assessed the level of AFHS 4Ms care received by these individuals in relation to their subsequent visit back to the clinic through descriptive statistics, a time-to-event analysis using the Kaplan-Meier cumulative incidence approach, and a Cox proportional Hazards model, adjusted for age, race, sex, prior appointments, and number of ICD-10 code diagnoses. Throughout the study period, patients who received complete AFHS 4Ms care exhibited greater rates of returning to the convenient care clinic compared to those who received partial or no 4Ms 4Ms care. Kaplan-Meier curves demonstrated that the cumulative probability of returning to the clinic was higher in patients that received 4Ms over time, compared to patients that did not receive 4Ms. Results from the Cox Proportional Hazards model demonstrated a risk ratio of 3.91 (p < .001) of returning to the clinic, after adjustment. The results indicate that patients are more likely to seek additional care in the future at the same health system when they receive complete 4Ms care, possibly due to increased satisfaction with care. As patient satisfaction is an indicator of quality care, this finding can further inform and spread the AFHS movement.

老年人友好型卫生系统的结果:在4分钟的护理后返回诊所。
随着越来越多的医疗系统实施4m框架,美国的老年友好医疗系统(AFHS)运动继续发展。尽管有这种增长,但评估AFHS实施相关结果的研究相对较少。本研究通过分析患者返回诊所接受未来医疗服务的比率,作为质量的衡量标准,来评估患者对AFHS的满意度。回顾性队列设计采用电子健康记录(EHR)数据,这些数据来自2021年1月至2024年3月期间在美国大型全国便利护理诊所网络接受治疗的65岁及以上患者(N = 987,197)。我们通过描述性统计、Kaplan-Meier累积发生率法的事件时间分析和Cox比例风险模型(调整了年龄、种族、性别、先前预约和ICD-10代码诊断的数量)评估这些个体接受的AFHS 4Ms护理水平与他们随后返回诊所的关系。在整个研究期间,接受完整的AFHS 4Ms护理的患者与接受部分或未接受4Ms护理的患者相比,显示出更高的返回便利护理诊所的比率。Kaplan-Meier曲线显示,随着时间的推移,与未接受4Ms治疗的患者相比,接受4Ms治疗的患者返回诊所的累积概率更高。Cox比例风险模型的结果显示,风险比为3.91 (p
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来源期刊
CiteScore
2.50
自引率
0.00%
发文量
192
审稿时长
>12 weeks
期刊介绍: INQUIRY is a peer-reviewed open access journal whose msision is to to improve health by sharing research spanning health care, including public health, health services, and health policy.
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