干旱区生态环境知识资源中心(Arid): Does Early Follow-Up Improve the Outcomes of Sepsis Survivors Discharged to Home Health Care?

Arid

DOI	10.1097/MLR.0000000000001152
	Does Early Follow-Up Improve the Outcomes of Sepsis Survivors Discharged to Home Health Care?
	Deb, Partha 1,2; Murtaugh, Christopher M.3; Bowles, Kathryn H.3,4; Mikkelsen, Mark E.5; Khajavi, Hoda Nouri 1,6; Moore, Stanley ; Barron, Yolanda 3; Feldman, Penny H.3
通讯作者	Deb, Partha
来源期刊	MEDICAL CARE
ISSN	0025-7079
EISSN	1537-1948
出版年	2019
卷号	57 期号:8 页码:633-640
英文摘要	Background: There is little evidence to guide the care of over a million sepsis survivors following hospital discharge despite high rates of hospital readmission. Objective: We examined whether early home health nursing (first visit within 2 days of hospital discharge and at least 1 additional visit in the first posthospital week) and early physician follow-up (an outpatient visit in the first posthospital week) reduce 30-day readmissions among Medicare sepsis survivors. Design: A pragmatic, comparative effectiveness analysis of Medicare data from 2013 to 2014 using nonlinear instrumental variable analysis. Subjects: Medicare beneficiaries in the 50 states and District of Columbia discharged alive after a sepsis hospitalization and received home health care. Measures: The outcomes, protocol parameters, and control variables were from Medicare administrative and claim files and the home health Outcome and Assessment Information Set (OASIS). The primary outcome was 30-day all-cause hospital readmission. Results: Our sample consisted of 170,571 mostly non-Hispanic white (82.3%), female (57.5%), older adults (mean age, 76 y) with severe sepsis (86.9%) and a multitude of comorbid conditions and functional limitations. Among them, 44.7% received only the nursing protocol, 11.0% only the medical doctor protocol, 28.1% both protocols, and 16.2% neither. Although neither protocol by itself had a statistically significant effect on readmission, both together reduced the probability of 30-day all-cause readmission by 7 percentage points (P=0.006; 95% confidence interval=2, 12). Conclusions: Our findings suggest that, together, early postdischarge care by home health and medical providers can reduce hospital readmissions for sepsis survivors.
英文关键词	posthospital medical care readmission sepsis nonlinear instrumental variables home health care
类型	Article
语种	英语
国家	USA
收录类别	SCI-E ; SSCI
WOS记录号	WOS:000479108900010
WOS关键词	HOSPITAL READMISSION ; HEART-FAILURE ; INTERVENTIONS ; CONSEQUENCES ; VALIDITY ; OASIS ; COST
WOS类目	Health Care Sciences & Services ; Health Policy & Services ; Public, Environmental & Occupational Health
WOS研究方向	Health Care Sciences & Services ; Public, Environmental & Occupational Health
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/217567
作者单位	1.CUNY, Hunter Coll, New York, NY 10021 USA; 2.NBER, New York, NY USA; 3.Visiting Nurse Serv New York, Ctr Home Care Policy & Res, New York, NY USA; 4.Univ Penn, Sch Nursing, Philadelphia, PA 19104 USA; 5.Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA; 6.CUNY, Grad Ctr, New York, NY USA
推荐引用方式 GB/T 7714	Deb, Partha,Murtaugh, Christopher M.,Bowles, Kathryn H.,et al. Does Early Follow-Up Improve the Outcomes of Sepsis Survivors Discharged to Home Health Care?[J],2019,57(8):633-640.
APA	Deb, Partha.,Murtaugh, Christopher M..,Bowles, Kathryn H..,Mikkelsen, Mark E..,Khajavi, Hoda Nouri.,...&Feldman, Penny H..(2019).Does Early Follow-Up Improve the Outcomes of Sepsis Survivors Discharged to Home Health Care?.MEDICAL CARE,57(8),633-640.
MLA	Deb, Partha,et al."Does Early Follow-Up Improve the Outcomes of Sepsis Survivors Discharged to Home Health Care?".MEDICAL CARE 57.8(2019):633-640.