重度脓毒症/感染性休克再入院成人患者在BPCI高级方案下的评估

IF 1 4区 医学 Q4 HEALTH CARE SCIENCES & SERVICES American Journal of Medical Quality Pub Date : 2022-09-01 DOI:10.1097/JMQ.0000000000000072
Pamela A Crabtree, Harry Bach, Eivind Del Fierro, Krystal Hunter, Kristian Quevada, Christa Schorr
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引用次数: 0

摘要

护理改善高级计划捆绑付款(BPCI-A)旨在支付一次付款,涵盖护理期间提供的服务。脓毒症与再入院率、死亡率和医疗费用增加有关。本研究的目的是评估90天内再次入院的败血症患者与未再次入院的败血症患者。这是一项回顾性队列研究,纳入了271例(110例再入院)患者,这些患者的诊断相关分组代码为败血症或严重败血症。皮肤/软组织感染是最常见的感染。两组出院时的资源需求(包括伤口护理)差异有统计学意义(25.45% vs 11.18%;P = 0.002)和物理治疗(74.55% vs 57.14%;P = 0.004)。再入院患者死亡率为43.64%,非再入院患者为26.71% (P = 0.004)。确定再入院的危险因素,提供适当的资源和随访可能有助于改善BPCI项目中脓毒症患者的预后。
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Evaluation of Adult Patients Readmitted for Severe Sepsis/Septic Shock Under the BPCI Advanced Program.

Bundled Payments for Care Improvement-Advanced Program (BPCI-A) is designed to pay a single payment covering services provided during an episode of care. Sepsis is associated with increased readmissions, mortality, and health care costs. The purpose of the study was to evaluate the BPCI program patients with sepsis who were readmitted within 90 days versus not readmitted. This was a retrospective cohort study including 271 (110 readmitted) patients enrolled in the BPCI program with Diagnostic-Related Grouping codes of septicemia or severe sepsis. Skin/soft tissue infection was the most common infection. There was a significant difference between the groups for resource needs at discharge including wound care (25.45% versus 11.18%; P = 0.002) and physical therapy (74.55% versus 57.14%; P = 0.004). Mortality was higher among readmissions, 43.64% versus 26.71% no readmission ( P = 0.004). Identifying risk factors for readmission, providing appropriate resources, and follow-up may contribute to improved patient outcomes for patients with sepsis enrolled in the BPCI program.

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来源期刊
CiteScore
1.90
自引率
7.10%
发文量
124
审稿时长
6-12 weeks
期刊介绍: The American Journal of Medical Quality (AJMQ) is focused on keeping readers informed of the resources, processes, and perspectives contributing to quality health care services. This peer-reviewed journal presents a forum for the exchange of ideas, strategies, and methods in improving the delivery and management of health care.
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