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Interdisciplinary Care: The Health Care Team-I01:21

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再入院を減らすために移動可能な統合医療移行ケアプログラムを評価する:準実験的設計からの発見

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  • 1Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.

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パラメディカルが主導するモバイル・インテグレーテッド・ヘルス (MIH) プログラムは,PACEDの介入のように,退院後の高齢者の30日間の再入院を大幅に削減します. このアプローチは,現場で老化を支援し,移行期介護の成果を改善します.

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コミュニティ・パラメディシン緊急医療サービス 緊急医療サービス移動可能な統合医療急性治療後のケアについてです.トランジション・ケア・トランジション・ケア

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科学分野:

  • ゲロントロジーはゲロントロジーの学科です.
  • 医療サービス 研究 医療サービス
  • モバイル・インテグレテッド・ヘルス

背景:

  • 退院は高齢者にとって脆弱な時期であり,医療,機能,社会的な衰退のリスクが高まります.
  • モバイル・インテグレーテッド・ヘルス (MIH) プログラムは,移行期医療のギャップに対する潜在的な解決策を提供します.
  • 弱い高齢者の退院後のケアにおけるMIHの有効性は,さらなる評価を必要としています.

研究 の 目的:

  • パラメディカル・アシスタント・コミュニティ・エヴァリューエーション (放出後) (PACED) の介入が30日間の再入院率に与える影響を評価する.
  • PACEDの介入と30日間の緊急治療室 (ED) の利用との関連性を評価する.
  • 病院入院後の移行期における脆弱な高齢者の支援におけるMIHの役割を調査する.

主な方法:

  • 将来の観察研究デザインが採用されました.
  • 都市学術医療センターから退院した高齢者は,72時間以内に救急医療従事者の自宅訪問 (PACED介入) を申し出ました.
  • 比較群は,プログラム領域の外に住んでおり,システム関連PCPが欠如している,または訪問を拒否した患者を用いて設立され,Poisson回帰を改変した結果が分析されました.

主要な成果:

  • PACED介入グループ (n=190) は,比較グループ (n=107,21.5%) に比べて,30日間の再入院率 (12.6%) が著しく低下した.
  • 再入院の調整された相対リスクは,PACED参加者の0.45 (95%CI:0.26-0.77,p=0.003) でした.
  • PACED参加者はまた,30日間のED訪問が少なくなった (11.5%対18.7%,調整RR0.58,p=0.05).

結論:

  • PACEDのような在宅MIH移行ケアプログラムは,弱い高齢者の30日再入院率の低下と関連しています.
  • これらの発見は,MIHが老化をサポートする貴重なモデルであることを示唆しています.
  • MIHの介入は,高齢者フレンドリーな医療システムへの統合の可能性を示しています.