按医院类型划分的心力衰竭和肺炎超额再诊断率

Viraj Brahmbhatt
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引用次数: 0

摘要

提高医疗质量是现代医疗保健的主要目标。护理质量通常通过心力衰竭、肺炎、膝关节/髋关节置换术等特定疾病的再入院率来衡量。医疗保险和医疗补助服务中心(CMS)已使用这些数据来调整再入院率过高的医院的报销率。不同的医院运营和管理模式具有结构性差异,可能会影响再入院率。这项研究调查了学术性、非营利性和营利性医院的再入院率是否存在显著差异。这一结果可能对重新制定基于再入院率评估医院的指南具有重要意义。非营利医院因心力衰竭再次入院的平均人数为1.0047人,营利性医院为1.013人,学术医院为0.975人。该集合的方差分析返回的p值为1.70284E-05,这意味着结果具有统计学意义。因此,从统计数据来看,学术医院的心力衰竭再入院率较低。非营利医院的肺炎超额再入院率为1.025,营利医院为1.024,学术医院为0.99。方差分析返回的p值为2.4899E-09,这表明所看到的差异具有统计学意义。因此,从统计数据来看,学术医院的肺炎再次入院率也较低。这项研究对消费者在选择医院时的决策具有启示意义。除此之外,基准测试算法以及CMS对报销率的调整可能会考虑考虑医院所有权类型。Doi:10.28991/SciMedJ-2022-04-02-03全文:PDF
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Excess Readmission rates for Heart Failure and Pneumonia by Hospital Type
The improvement of quality care is a major goal for modern healthcare. Quality of care is often measured through readmission rates for specific conditions such as heart failure, pneumonia, total arthroplasty of the knee/hip, etc. This data has been used by the Center for Medicare and Medicaid Services (CMS) to adjust reimbursement rates for hospitals with excessive readmissions. Different hospital operations and management models possess structural differences that may impact the rates of readmission. This study investigated whether there were significant differences in the readmission rates for academic, non-profit, and for-profit hospitals. The results may be important in reshaping guidelines to assess hospitals based on readmission rates. The average excess readmissions for heart failure were in non-profit hospitals for 1.0047, for-profit hospitals for 1.013, and academic hospitals for 0.975. The ANOVA for this set returned a p-value of 1.70284E-05, meaning that the results were statistically significant. As such, academic hospitals have statistically lower readmission rates for heart failure. The excess readmission rates for pneumonia yielded 1.025 for non-profit, 1.024 for for-profit, and 0.99 for academic hospitals. The ANOVA returned a p-value of 2.4899E-09, which suggests the differences seen are statistically significant. As such, academic hospitals also have a statistically lower rate of pneumonia readmissions. The study has implications for consumer decision-making when choosing a hospital. In addition to this, algorithms for benchmarking as well as CMS adjustments to reimbursement rates may consider factoring in the hospital ownership type. Doi: 10.28991/SciMedJ-2022-04-02-03 Full Text: PDF
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