Photo: David Sacks/Getty Images

照片：DavidSacks/Getty Images

The Centers for Medicare and Medicaid Services is releasing data on the Acute Hospital Care at Home initiative through the Research and Data Assistance Center.

医疗保险和医疗补助服务中心（Centers for Medicare and Medicaid Services）正在通过研究和数据援助中心（Research and data Assistance Center）发布有关家庭急性医院护理计划的数据。

ResDAC collected data from November 27, 2020, through March 30, 2023. As required for participation, hospitals agreed to report to CMS either weekly or monthly.

ResDAC收集了2020年11月27日至2023年3月30日的数据。根据参与要求，医院同意每周或每月向CMS报告。

The Acute Hospital Care at Home program was among the flexibilities CMS allowed during the public health emergency as a Section 1135 waiver.

作为第1135节的豁免，在公共卫生紧急情况下，CMS允许在家中进行急性医院护理计划。

The expiration of the COVID-19 public health emergency in May 2023 ended many of the waivers. Others that were shown to be successful both for patients and hospitals remained in place under the Consolidated Appropriations Act of 2023. The CAA extended waivers and flexibilities associated with telehealth and also for the Acute Hospital Care at Home program until December 31, 2024..

2023年5月，新型冠状病毒肺炎（COVID-19）突发公共卫生事件（public health emergency）到期，终止了许多豁免。根据2023年的《综合拨款法》，其他被证明对患者和医院都很成功的项目仍然存在。CAA将与远程医疗相关的豁免和灵活性以及在家急性医院护理计划的豁免和灵活性延长至2024年12月31日。。

CMS said the Consolidated Appropriations Act requires specific data collection for the purpose of conducting a study. Continuation of the AHCAH initiative beyond December 31 is contingent on further Congressional action, CMS said.

CMS表示，《综合拨款法》要求为进行研究收集具体数据。CMS表示，AHCAH倡议能否在12月31日之后继续实施，取决于国会的进一步行动。

Both patients – and hospitals that have the scale to establish acute care at home programs – have reportedly liked the program. Hospitals found a financial advantage to transferring lower acuity patients to the home, freeing up beds for sicker patients.

据报道，患者和有规模建立家庭急救计划的医院都喜欢该计划。医院发现将视力较低的患者转移到家中，为病情较重的患者腾出床位，具有财务优势。

Whether hospital investments in the program will bring ROI long-term depends on a 'Super Bowl' of legislative policy decisions this year.

医院对该项目的投资能否带来长期的投资回报率，取决于今年的“超级碗”立法政策决定。

'With nearly all of the flexibilities established during the COVID-19 public health emergency extended until the end of 2024, we can expect a telehealth policy 'Super Bowl' at the end of next year,' American Telemedicine Association SVP of public policy Kyle Zebley said in November,

美国远程医疗协会公共政策高级副总裁凯尔·泽布利（KyleZebley）11月表示，由于新型冠状病毒肺炎（COVID-19）公共卫生紧急情况期间建立的几乎所有灵活性都延长到2024年底，我们可以预计明年底将推出远程医疗政策“超级碗”，

WHY THIS MATTERS

为什么这很重要

As of March 20 of this year, 277 hospitals across 123 systems in 37 states were approved to participate in the Acute Hospital Care at Home program, according to CMS research published in November 2023 in the Journal of the American Medical Association.

根据2023年11月在《美国医学会杂志》上发表的CMS研究报告，截至今年3月20日，37个州123个系统的277家医院被批准参加家庭急性医院护理计划。

From November 25, 2021 through March 20, 2023, 11,159 patients were admitted into the program. The most common conditions treated, based on the primary diagnosis, were respiratory infections, heart failure and shock, and severe sepsis or septicemia, all with a major complication and comorbidity.

从2021年11月25日到2023年3月20日，共有11159名患者被纳入该计划。根据初步诊断，治疗的最常见疾病是呼吸道感染，心力衰竭和休克，以及严重的败血症或败血症，所有这些都有严重的并发症和合并症。

For Medicare patients, the median length of stay was five days. The overall proportion of patients transferred from home back to the hospital was 7.2%.

对于医疗保险患者，中位住院时间为五天。从家中转移回医院的患者总比例为7.2%。

During the study period, 38 unexpected deaths (0.34%) occurred in participating hospitals. Most unexpected deaths occurred in the setting of COVID-19 infection with the progression of more severe illness symptoms.

在研究期间，参与医院发生了38例意外死亡（0.34%）。大多数意外死亡发生在新型冠状病毒感染的情况下，伴随着更严重的疾病症状的进展。

With the exception of three cases, each of the patients who died had been transferred back to the hospital and received medical or intensive care unit– level care for several days prior to death.

除三例外，每位死亡患者在死亡前几天都被转移回医院接受医疗或重症监护病房级别的护理。

THE LARGER TREND

更大的趋势

CMS launched  the Acute Hospital Care at Home initiative in November 2020 in response to challenges faced by hospitals because of the spread of COVID-19. CMS allowed certain Medicare-certified hospitals to treat patients with inpatient-level care at home using Section 1135 waivers of the Social Security Act..

CMS于2020年11月启动了家庭急性医院护理计划，以应对医院因新型冠状病毒传播而面临的挑战。CMS允许某些医疗保险认证的医院使用《社会保障法》第1135节的豁免条款在家中治疗住院病人。。

Acute Hospital Care at Home expanded on the broader 'Hospital Without Walls' initiative. It allowed hospitals to seek waivers suspending the requirements for nursing services to be provided on premises 24 hours a day, seven days a week, and for a registered nurse to be immediately available.

在更广泛的“无墙医院”倡议下，家庭急性医院护理得到了扩展。它允许医院寻求豁免，暂停要求医院提供每周7天、每天24小时的护理服务，并立即提供注册护士。

Hospitals providing care in patients' homes continued to meet all health and safety requirements that were not waived through the public health emergency waiver authority under Section 1135 of the Act.

在患者家中提供护理的医院继续满足该法案第1135节规定的公共卫生紧急豁免管理局未豁免的所有健康和安全要求。

Email the writer: SMorse@himss.org

给作者发电子邮件：SMorse@himss.org