PT - 杂志 - 牛牛，京波奥 - 赛德，玛丽姆库尔·奥 - Winkelmayer，Wolfgang C. Au - Erickson，Kevin F.TI - 患者在美国援助封闭后的透析设施封闭术后 - 10.1681 / ASN .2021020244DP - 2021 Oct 01 TA - 美国肾病学会PG - 万博体育max3 2613--2621 VI - 32 IP - 10 4099 - //www.inmeli.com/content/32/10/2613.short 4100 - http：//www.inmeli.com/content/32/10/2613.full so - J.AM。SOC。Nephrol.2021 10月01日;32 AB - 虽然在美国透析护理的报销恢复的持续变化可能会增加透析设施封闭的风险，但这种封闭对患者健康结果的影响是未知的。作者审查了透析设施封闭和住院和死亡率之间的关联。由透析设施影响的患者从2001年1月到2014年4月的住院率，与在没有接近的设施的设施的类似患者的住院率相比，预留率高7％-9％。与未受影响的患者相比，受闭环影响的患者也表现出较高的死亡率，尽管这种差异是边界统计学意义。这些调查结果强调了对不断减轻设施封闭风险的有效政策的必要性。守报透析护理的恢复持续变化可能会增加透析设施封闭的风险。关闭可能对接受透析的患者的健康特别有害，他们是医学上复杂和临床上的。方法我们使用了两种单独的分析策略 - 使用基于设施的匹配和其他使用倾向得分匹配 - 比较接受患者的健康结果 in-center hemodialysis at United States facilities that closed with outcomes of similar patients who were unaffected. We used negative binomial and Cox regression models to estimate associations of facility closure with hospitalization and mortality in the subsequent 180 days.Results We identified 8386 patients affected by 521 facility closures from January 2001 through April 2014. In the facility-matched model, closures were associated with 9% higher rates of hospitalization (relative rate ratio [RR], 1.09; 95% confidence interval [95% CI], 1.03 to 1.16), yielding an absolute annual rate difference of 1.69 hospital days per patient-year (95% CI, 0.45 to 2.93). Similarly, in a propensity-matched model, closures were associated with 7% higher rates of hospitalization (RR, 1.07; 95% CI, 1.00 to 1.13; P=0.04), yielding an absolute rate difference of 1.08 hospital days per year (95% CI, 0.04 to 2.12). Closures were associated with nonsignificant increases in mortality (hazard ratio [HR], 1.08; 95% CI, 1.00 to 1.18; P=0.05 for the facility-matched comparison; HR, 1.08; 95% CI, 0.99 to 1.17; P=0.08 for the propensity-matched comparison).Conclusions Patients affected by dialysis facility closures experienced increased rates of hospitalization in the subsequent 180 days and may be at increased risk of death. This highlights the need for effective policies that continue to mitigate risk of facility closures.