专业护理机构的干预分析与减少再入院率有关。

IF 2.5 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Derek A Kaknes, Tanner B Barbour, Wenyan Ji, Steven M Stein, Mary D Naylor, Alexandra L Hanlon
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引用次数: 0

摘要

目的评估与宾夕法尼亚州医学中心兰开斯特综合医院(LGH)相关的专业护理机构(SNFs)30天风险调整后再入院率的纵向分布差异,这些机构实施了介入分析(IA)平台,与其他未实施IA的LGH机构相比,与宾夕法尼亚州的其他SNFs相比,与所有其他州的机构相比:对2017年至2022年的CMS再入院数据进行回顾性纵向分析,并使用CMS质量指标数据进行横截面分析:对 CMS SNF 质量绩效数据进行汇总,并按设施和时间段与风险调整后的再入院率进行比较。根据地点、与 LGH 的转诊关系以及是否实施了 IA,将每个 SNF 分配到一个队列中。采用多变量混合效应模型比较各组群的再入院情况,同时对2022年第四季度的质量指标进行描述性比较:结果:LGH的情况与州和全国的情况都有很大不同,LGH设施利用IA的情况差异更大。在截至2022年第四季度的最近12个月中,与未实施IA的LGH SNF、宾夕法尼亚州和全国同类机构相比,实施IA的LGH SNF的估计再入院率分别低15.24、12.30和13.06个百分点(所有配对P结论):与全国、全州以及同一SNF转诊网络中的同行相比,实施所研究的IA平台的SNF在统计和临床上都显示出显著的风险调整后再入院率优势(P<0.05)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Interventional analytics in skilled nursing facilities associated with reduced readmissions.

Objective: To assess differences in longitudinal profiles for 30-day risk-adjusted readmission rates in skilled nursing facilities (SNFs) associated with Penn Medicine's Lancaster General Hospital (LGH) that implemented an interventional analytics (IA) platform vs other LGH facilities lacking IA vs other SNFs in Pennsylvania vs facilities in all other states.

Study design: Retrospective longitudinal analysis of CMS readmissions data from 2017 through 2022, and cross-sectional analysis using CMS quality metrics data.

Methods: CMS SNF quality performance data were aggregated and compared with risk-adjusted readmissions by facility and time period. Each SNF was assigned to a cohort based on location, referral relationship with LGH, and whether it had implemented IA. Multivariable mixed effects modeling was used to compare readmissions by cohort, whereas quality measures from the fourth quarter of 2022 were compared descriptively.

Results: LGH profiles differed significantly from both state and national profiles, with LGH facilities leveraging IA demonstrating an even greater divergence. In the most recent 12 months ending in the fourth quarter of 2022, LGH SNFs with IA had estimated readmission rates that were 15.24, 12.30, and 13.06 percentage points lower than the LGH SNFs without IA, Pennsylvania, and national cohorts, respectively (all pairwise P < .0001). SNFs with IA also demonstrated superior CMS claims-based quality metric outcomes for the 12 months ending in the fourth quarter of 2022.

Conclusions: SNFs implementing the studied IA platform demonstrated statistically and clinically significant superior risk-adjusted readmission rate profiles compared with peers nationally, statewide, and within the same SNF referral network (P < .0001). A more detailed study on the use of IA in this setting is warranted.

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来源期刊
American Journal of Managed Care
American Journal of Managed Care 医学-卫生保健
CiteScore
3.60
自引率
0.00%
发文量
177
审稿时长
4-8 weeks
期刊介绍: The American Journal of Managed Care is an independent, peer-reviewed publication dedicated to disseminating clinical information to managed care physicians, clinical decision makers, and other healthcare professionals. Its aim is to stimulate scientific communication in the ever-evolving field of managed care. The American Journal of Managed Care addresses a broad range of issues relevant to clinical decision making in a cost-constrained environment and examines the impact of clinical, management, and policy interventions and programs on healthcare and economic outcomes.
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