Post Hospital Transition Care Among Patients

患者的出院后过渡护理

基本信息

批准号：
8573133
负责人：
CHARLES W GIVEN
金额：
$ 7.68万
依托单位：
MICHIGAN STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-15 至 2014-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8573133
关键词：
Accounting Address Age Age-Years Caring Categories Chronic Comorbidity Complex Custodial Care Data Data Set Demographic Aging Developmental Disabilities Diagnosis Disease Economics Elements Eligibility Determination End stage renal failure Enrollment Expenditure Family Foundations Funding Future Goals Grouping Health Status Healthcare Home Care Services Home Nursing Care Home environment Hospitalization Hospitals Inpatients Intensive Care Link Medicaid Medical Medical Indigency Medicare Medicare Part A Medicare/Medicaid Michigan Modeling Nursing Homes Outpatients Patients Pattern Performance Persons Population Public Health Reporting Research Risk Role Savings Services System Time United States Centers for Medicare and Medicaid Services base beneficiary community based service cost demographics design hospice environment improved meetings multiple chronic conditions patient home care residence severe mental illness sex

项目摘要

Dually eligible (Medicare Medicaid) patients have high rates of multiple chronic conditions, poor performance, and heavy use of medical care services. The dually eligible include all persons who are 65 years of age and older and who meet state criteria for being medically indigent as well as patients with severe developmental disabilities, serious mental illness, or complex comorbid conditions This application will conduct secondary analyses of Medicare (Parts A, B, and D) linked with Medicaid claim and encounter data and the Minimum Data Set information for both home and nursing home care services for the period of 01/01/2008 through 12/31/2011. As defined, 198,644 patients are eligible and available for analyses. The goal of this application is to conduct secondary analyses of this large complex data set in order to determine the role of demographics, sub population beneficiary categories, multiple chronic conditions, and discharge diagnoses are associated with configurations of post hospital transition care and, in turn, the impact of transition care configurations on: a) subsequent hospitalizations, b) the time between hospitalizations described as time at home or in the least intensive care setting and c) the costs of services between each hospital discharge and the subsequent hospitalization. Post hospital discharge configurations to be examined include; discharge to home with or without skilled home care, to nursing home for skilled care followed by custodial care, or directly to custodial nursing home care, or to hospice. .All analyses will adjust for age, sex, sub population beneficiary categories, number and type of chronic conditions, and discharge diagnoses. Each configuration of transition care will be treated as a multi-nomial dependent variable and analyzed over time. This application is significant because these analyses can, based on demographics and numbers of chronic conditions, suggest which discharge strategies are associated with longer time at home, fewer re-hospitalizations, and lower costs.

双重合格（Medicare Medicaid）患者的多种慢性病率很高，性能差，并大量使用医疗服务。双重合格包括所有65岁及以上的人谁符合医学贫穷的国家标准以及严重发育的患者残疾，严重的精神疾病或复杂的合并状况此应用将进行次要与Medicaid索赔和遭遇数据有关的Medicare（A，B部分）的分析以及最低数据设置2008年1月1日期间家庭和疗养院护理服务的信息 12/31/2011。如定义，198,644名患者有资格并用于分析。该应用的目的是对这个大型复杂数据集进行次要分析，以确定人口统计的作用，亚人口受益人类别，多种慢性病和出院诊断与后医院过渡护理的配置以及过渡护理配置的影响：a）随后住院，b）被描述为在家或至少的住院时间之间的时间重症监护设置和c）每次出院与随后的服务成本住院。检查后的出院配置包括：与或没有熟练的家庭护理，要养老院以进行熟练的护理，然后进行保管护理或直接进行监护权疗养院护理或临终关怀。所有分析都将调整年龄，性别，亚次人口受益人类别，慢性病的数量和类型，以及出院诊断。过渡护理的每种配置将是被视为多名因素变量并随着时间的流逝而分析。此应用程序很重要，因为这些分析可以基于人口统计和慢性条件的数量，表明哪些出院策略与较长的时间相关，重新建筑化较少以及成本较低。