前置式家庭医疗物理治疗减少了医疗保险付费服务受益人的再住院率。

IF 3.5 4区 医学 Q1 ORTHOPEDICS
Kevin McLaughlin, Joseph F Levy, Jenni S Reiff, Julia Burgdorf, Lisa Reider
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引用次数: 0

摘要

目的:本文旨在确定基于索赔的前置家庭健康理疗(HHPT)定义,并研究前置 HHPT 就诊对全因 30 天再入院的影响:本文旨在确定基于理赔的前置家庭健康理疗(HHPT)定义,并研究前置家庭健康理疗就诊对全因 30 天再入院率的影响:本研究采用了一项回顾性分析,分析对象是 "全国健康与老龄化趋势研究"(NHATS;2011-2017 年)中住院 30 天内接受过一次 HHPT 治疗的老年人(≥65 岁)(n = 1344 次住院;加权 n = 7,727,384 人)。对家庭医疗索赔分布进行了探索性分析,以确定前置 HHPT 的定义。然后使用广义线性模型来检验再入院与每种前置负荷定义之间的关系:结果:确定了四种前置 HHPT 定义:出院后第一周内 HHPT 就诊次数≥2 次;第一周内就诊次数≥3 次;前两周内就诊次数≥4 次;前两周内就诊次数≥5 次。在第一周接受前置 HHPT 治疗的老年人的调整后再入院风险较低:(风险比[RR]≥2 vs 结论:前置 HHPT 可降低老年人再次入院的风险:前置 HHPT 可降低医疗保险受益人的 30 天再入院率。需要开展更多研究,以确定最佳就诊次数以及最有可能从前负荷 HHPT 中受益的人群:影响:前置 HHPT 可以有效降低医疗保险受益人的 30 天再入院率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Frontloaded Home Health Physical Therapy Reduces Hospital Readmissions among Medicare Fee-for-Service Beneficiaries.

Objective: The purpose of this paper is to determine a claims-based definition of frontloaded home health physical therapy (HHPT) and examine the effect of frontloaded HHPT visits on all-cause 30-day hospital readmissions.

Methods: This study used a retrospective analysis of Medicare fee-for-service claims from older adults (≥65 years) in the National Health and Aging Trends Study (NHATS; 2011-2017) with ≥1 HHPT visit within 30 days of a hospitalization (n = 1344 hospitalizations; weighted n = 7,727,384). An exploratory analysis of home health claim distribution was conducted to determine definitions of frontloaded HHPT. Generalized linear models were then used to examine the relationship between hospital readmission and each definition of frontloading.

Results: Four definitions of frontloaded HHPT were identified: ≥2 HHPT visits in the first week after discharge; ≥3 visits in the first week; ≥4 visits in the first 2 weeks; and ≥ 5 visits in the first 2 weeks. The adjusted risk of readmission was lower for older adults receiving frontloaded HHPT in the first week: (risk ratio [RR] for ≥2 vs <2 visits = 0.57; 95% CI = 0.41-0.79; RR for ≥3 vs <3 visits = 0.39; 95% CI = 0.22-0.72). The reduction in risk of readmission was even greater for older adults receiving ≥4 versus <4 HHPT visits (RR = 0.32; 95% CI = 0.21-0.48) and ≥ 5 versus <5 HHPT visits (RR = 0.27; 95% CI = 0.14-0.50) within the first 2 weeks. The effect of HHPT frontloading was greater for patients hospitalized with surgical versus medical diagnoses and for patients with diagnoses targeted by the Hospital Readmissions Reduction Program.

Conclusion: Frontloaded HHPT reduces 30-day hospital readmissions among Medicare beneficiaries. Additional research is needed to determine the optimal number of visits and those most likely to benefit from frontloaded HHPT.

Impact: Frontloaded HHPT can be an effective approach for reducing 30-day hospital readmissions among Medicare beneficiaries.

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来源期刊
Physical Therapy
Physical Therapy Multiple-
CiteScore
7.10
自引率
0.00%
发文量
187
审稿时长
4-8 weeks
期刊介绍: Physical Therapy (PTJ) engages and inspires an international readership on topics related to physical therapy. As the leading international journal for research in physical therapy and related fields, PTJ publishes innovative and highly relevant content for both clinicians and scientists and uses a variety of interactive approaches to communicate that content, with the expressed purpose of improving patient care. PTJ"s circulation in 2008 is more than 72,000. Its 2007 impact factor was 2.152. The mean time from submission to first decision is 58 days. Time from acceptance to publication online is less than or equal to 3 months and from acceptance to publication in print is less than or equal to 5 months.
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