Annapoorna Mary, Fawaz Mzayek, Leanne L Lefler, Yu Joyce Jiang, Meghan Meadows Taylor
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引用次数: 0
摘要
研究目的:冠状动脉旁路移植术(CABG)术后患者 30 天再入院与发病率和死亡率的增加有关。病例管理和后续护理等干预措施可减少 30 天再入院率。本文旨在报告一项关于可改变因素的研究,这些因素可能对病例管理预防 CABG 术后再入院具有重要意义:研究对象包括2013年1月1日至2016年1月1日期间在一家中南部医院首次接受CABG手术的所有成年患者:采用回顾性病例对照研究,对1712名接受过CABG手术的患者进行了研究:结果显示,30 天内再次入院的患者住院时间(LOS)明显较短(6 天 vs. 10 天;p < .0001),在重症监护室的住院天数较多(6 天 vs. 4 天;p = .0391),糖尿病/肾病(4% vs. 1%)、感染(17% vs. 2%)和呼吸系统相关诊断(10% vs. 1%;p < .0001)明显较高:在这些因素中,住院时间是一个主要因素,除了其他可改变的风险因素外,还可以通过病例管理来解决。了解与再入院风险较高相关的可改变因素对于有效干预和病例管理规划至关重要。
Case Management in Prevention of 30-Day Readmission in Post-Coronary Artery Bypass Graft Surgery.
Purpose of study: Thirty-day readmission is associated with increased morbidity and mortality among postoperative coronary artery bypass graft (CABG) surgery patients. Interventions such as case management and follow-up care may reduce 30-day readmission. The purpose of this article is to report a study on modifiable factors that may have significant implications for case management in the prevention of readmission after CABG surgery.
Primary practice settings: The study population included all the adult patients who underwent first-time CABG surgery from January 1, 2013, to January 1, 2016, from a Mid-South hospital.
Methodology and sample: A retrospective case-control study was employed to examine 1,712 patients who underwent CABG surgery.
Results: The results revealed that patients readmitted within 30 days had a significantly shorter length of stay (LOS) (6 days vs. 10 days; p < .0001), more days in intensive care unit (6 days vs. 4 days; p = .0391), and significantly higher diabetes/renal (4% vs. 1%), infection (17% vs. 2%), and respiratory-related diagnoses (10% vs. 1%; p < .0001).
Implications for case management practice: Among these factors, hospital LOS is a major factor that can be addressed through case management in addition to other modifiable risk factors. Understanding modifiable factors associated with higher readmission risk is crucial for effective intervention and case management planning.
期刊介绍:
Professional Case Management: The Leader in Evidence-Based Practice is a peer-reviewed, contemporary journal that crosses all case management settings. The Journal features best practices and industry benchmarks for the professional case manager and also features hands-on information for case managers new to the specialty. Articles focus on the coordination of services, management of payer issues, population- and disease-specific aspects of patient care, efficient use of resources, improving the quality of care/patient safety, data and outcomes analysis, and patient advocacy. The Journal provides practical, hands-on information for day-to-day activities, as well as cutting-edge research.