Nnyocha nke ngụghachi ụlọ ọgwụ maka oyi baa obodo (CAP) na France chọpụtara na ngụgharị ole na ole ka a ga-ezere, na-akwado nkatọ na nha ahụ nwere ike ibute ntaramahụhụ na-ezighi ezi na atụmatụ ịkwụ ụgwọ maka ịrụ ọrụ.
A na-ezere ngụghachi ole na ole mgbe ụlọ ọgwụ maka oyi oyi nke obodo nwetara, nchọpụta ọhụrụ na France achọpụtala, na-atụ aro na ihe ngosi a nwere ike ọ gaghị abụ ihe kwesịrị ekwesị maka mmemme ịkwụ ụgwọ ụlọ ọgwụ.
Ọmụmụ otu ndị otu nleba anya nlegharị anya nke e bipụtara na JAMA Network Open gụnyere ndị ọrịa 1150 nwere oyi oyi nke obodo nwetara bụ ndị ụlọ ọgwụ na Grenoble University Hospital na Annecy General Hospital na France na 2014.
Bastien Boussat, MD, nke ngalaba na-ahụ maka ọrịa na-efe efe na ụlọ ọgwụ Grenoble University dị na Grenoble, France, gwara Contagion: "Ọ bụ naanị obere pasentị nke nlọghachi mgbe a gachara ụlọ ọgwụ maka oyi oyi ka a na-egbochi (ihe na-erughị otu n'ime 10 remissions)."
Ọmụmụ ihe ahụ gụnyere ụmụ nwoke 651 (56.6%) nwere afọ 77.8, ndị ọrịa 98 (8.5%) nwụrụ n'ụlọ ọgwụ, ndị ọrịa 184 ka a na-anabataghachi n'ime ụbọchị 30, na 108 (9.4%) na-agụghachi na mberede.
Data anakọtara gụnyere ihe nrịanrịa, klaasị oke oyi oyi index, nyocha anụ ahụ na nchọpụta ụlọ nyocha, nsonaazụ X-ray ma ọ bụ CT na nchọpụta microbiological, yana ọgwụgwọ na nsogbu.
Ọmụmụ ihe ahụ gụnyere nyochaa ndekọ ndekọ ụlọ ọgwụ site n'aka ndị ọkachamara ahụike bụ ndị nyochara ọdịdị na-emeghị atụmatụ, ọdịdị a na-ezere na ihe mere ị ga-eji gụgharịa. A na-enyocha ikpe ọ bụla site n'aka ndị ọkachamara 4 sitere na panel nke ndị dọkịta na-ahụ maka ụlọ akwụkwọ 9, gụnyere ndị ọkachamara ọrịa 3 na-efe efe, 3 pulmonologists, na 3 Clinical epidemiologists. The likelihood of avoidable readmission na Bayeriability classification bụ nke ọma site na iji nyocha akwụkwọ ikike nke Bayerib. karịa 50% e weere na a ga-ezere.
Iri na ise n'ime 108 a na-agụghị akwụkwọ na-agụghị akwụkwọ nwere akara puru omume nke dị n'azụ karịa 50% (13.9% nke 108 na-agụghị akwụkwọ; 95% CI, 8.0% -21.9%). Ndị ọrịa na-ezere ịgụ akwụkwọ maka ụbọchị 4 nwere oge dị mkpirikpi n'etiti nkwụsị na nkwụsịtụ ma e jiri ya tụnyere = .02 ụbọchị.
Boussat kwuru na ọ tụrụ ya n'anya maka ihe isi ike ndị ọkachamara nwere n'ịkwenye na a ga-egbochi agụgharị akwụkwọ na ọnụ ọgụgụ dị ala nke ngụgharị a na-egbochi.
N'ime 108 na-agụghị akwụkwọ, naanị 51 (47.2%) nwere nkwekọrịta zuru oke n'etiti ndị nyocha anọ nọọrọ onwe ha, gụnyere otu onye ọrịa nkewapụtara dị ka ihe a ga-ezere.
"Iji 30-day readmissions mgbe a CAP ụlọ ọgwụ iji chọpụta ngwa ngwa ịkwụ ụgwọ na ọha akuko nwere ike na-ezighị ezi ntaramahụhụ ụlọ ọgwụ," Boussat kwuru, na-ekwusi ike na "mgbe ikpe njirisi na-agụnye reviewer subjectivity, multiple onwe Review. Ndị a otutu nnwere onwe reviews nwere ike mfe nyocha site na iji latent Atiya analysis ụdị."
The Centers for Medicaid and Medicare Services launching a pay-for-performance program in 2008, linking Medicare reimbursement to hospital quality metrics.Pneumonia readmissions n'ime 30 ụbọchị e gụnyere na Ụlọ Ọgwụ Readmission Mbelata Program (HRRP) na 2012, dabere na echiche na readmissions bụ n'ozuzu zere.Kemgbe ahụ, Germany, France-na-eme atụmatụ ịkwụ ụgwọ maka UK. ndị edemede kwuo, na-achọpụta na a katọrọ ha maka na ha ejighị n'aka nke ọma mgbagwoju anya ahụike na enweghị ike nke ụfọdụ nlọghachi.
"Ndị ndọrọ ndọrọ ọchịchị nwere ike iwulite usoro mkpesa mba gburugburu usoro a na-eji n'ọmụmụ ihe a, nyocha ndị ọkachamara dabeere na nkwenye nke agụghachi," Boussat kwuru.
Oge nzipu: Eprel-21-2022