随机试验发现病例和监测老年人在家中的老年人
M S Pathy1, A Bayer, K Harding
1Department of Geriatric Medicine, University of Wales College of Medicine, Cardiff Royal Infirmary, UK.
Lancet (London, England)
|October 10, 1992
概括
使用邮政问卷和护士随访的老年人的家庭健康查降低了死亡率,改善了自我评估的健康状况. 这种方法还缩短了年轻老年患者的住院时间,优化了医疗保健资源的使用.
科学领域:
- 老年学是指老年学的学科.
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 关于在家居住的老年人进行健康查的有效性,争论仍在继续.
- 英国重新关注75岁及以上的人的年度评估,凸显了对有效查策略的需求.
- 查老年人带来了与医疗保健人力和资源分配有关的挑战.
研究的目的:
- 评估邮政查问卷与护士主导干预对老年患者健康结果和医疗资源利用的影响.
- 评估病例发现和监测对65岁及以上个体死亡率,生活质量,健康状况和服务使用的影响.
主要方法:
- 在南威尔士进行了一项随机对照试验,涉及65岁及以上的705名患者.
- 干预组 (369名患者) 收到了一封以功能为重点的邮寄问卷,随后由护士进行验证和干预.
- 对照组 (356名患者) 没有接受任何问卷或护士联系. 该研究的持续时间为3年.
主要成果:
- 与对照组 (24%) 相比,干预组 (18%) 的死亡率明显较低 (p < 0.05).
- 干预组的65-74岁患者的住院时间明显较短 (差异为4.6天,p < 0.01).
- 干预组的自我评估健康状况优于干预组,尽管生活质量测量没有显著差异. 增加的GP访问被较少的家庭访问所抵消.
结论:
- 邮政查问卷与选择性护士跟踪和干预相结合,可以对生活在家中的老年人的健康结果产生积极影响.
- 这一战略表明,在老年人群中对医疗保健资源的使用产生有利影响的潜力.
- 这些发现支持实施有针对性的查计划,以改善老年人护理和资源管理.
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