健康信息交换对老年阿尔茨海默病患者出院后30天内再入院住院和出院后死亡卡塔尔世界杯8强波胆分析率的影响医疗保险受益人队列研究%A Turbow,Sara %A Vaughan,Camille P %A Culler,Steven D %A Hepburn,Kenneth W %A Rask,Kimberly J %A Perkins,Molly M %A Clevenger,Carolyn K %A Ali,Mohammed K %+内科内科科，Emory大学医学院，49 Jesse Hill Jr Dr SE，佐治亚州亚特兰大，30303，美国，1 404 251 8897，sara.turbow@emory.edu %K再入院率%K护理碎片化%K健康信息交换%K死亡率%K阿尔茨海默病%K电子健康信息%K信息共享%K老年人%K信息交换%K医院系统%K健康信息%D 2023 %7 10.3.2023 %9原文%J JMIR Aging %G英语%X尽管电子健康信息共享在全国范围内不断扩大，但尚不清楚电子健康信息共享是否能改善患者的预后，特别是对那些沟通困难风险最高的患者，如患有阿尔茨海默病的老年人。目的:确定医院层面的健康信息交换(HIE)参与与老年痴呆症医疗保险受益人住院或出院后死亡率之间的关系，或因几种常见疾病之一入院后30天再入院。方法:这是一项队列研究，针对患有阿尔茨海默病的医疗保险受益人，他们在2018年因选择的医院再入院减少计划条件(急性心肌梗死、充血性心力衰竭、慢性阻塞性肺病和肺炎)或老年阿尔茨海默病住院的常见原因(脱水、晕厥、尿路感染或行为问题)首次入院后，有一次或多次30天再入院。使用未调整和调整的逻辑回归，我们检验了电子信息共享与再入院期间住院死亡率或再入院后30天死亡率之间的关系。结果:共纳入28946对再入院患者。同一医院再入院的受益人(81.1岁，SD 8.6岁)比不同医院再入院的受益人(79.8 ~ 80.3岁，P< 0.001)年龄大。与入院和再入院同一家医院相比，再入院与入院医院共享HIE的不同医院的受益人在再入院期间死亡的几率降低39%(调整优势比[AOR] 0.61, 95% CI 0.39-0.95)。 There were no differences in in-hospital mortality observed for admission-readmission pairs to different hospitals that participated in different HIEs (AOR 1.02, 95% CI 0.82-1.28) or to different hospitals where one or both hospitals did not participate in HIE (AOR 1.25, 95% CI 0.93-1.68), and there was no association between information sharing and postdischarge mortality. Conclusions: These results indicate that information sharing between unrelated hospitals via a shared HIE may be associated with lower in-hospital, but not postdischarge, mortality for older adults with Alzheimer disease. In-hospital mortality during a readmission to a different hospital was higher if the admission and readmission hospitals participated in different HIEs or if one or both hospitals did not participate in an HIE. Limitations of this analysis include that HIE participation was measured at the hospital level, rather than at the provider level. This study provides some evidence that HIEs can improve care for vulnerable populations receiving acute care from different hospitals. %M 36897638 %R 10.2196/41936 %U https://aging.www.mybigtv.com/2023/1/e41936 %U https://doi.org/10.2196/41936 %U http://www.ncbi.nlm.nih.gov/pubmed/36897638