住院经验与艾滋病患者死亡率之间的关系
V E Stone1, G R Seage, T Hertz
1Department of Medicine, Boston City Hospital, Boston University School of Medicine, MA.
JAMA
|November 18, 1992
概括
在治疗获得性免疫缺陷综合征 (艾滋病) 患者的经验较少的医院,死亡率较高. 这种增加的风险不是由于患者的疾病严重程度或资源利用差异.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 医疗保健管理的管理
背景情况:
- 获得性免疫缺陷综合征 (艾滋病) 是一种复杂的疾病,需要专门的护理.
- 医院艾滋病经验的变化可能会影响患者的治疗结果.
研究的目的:
- 调查医院艾滋病经验与患者死亡率之间的关联.
- 为了确定疾病的严重程度,排放模式或资源使用是否解释了这种关联.
主要方法:
- 基于人口的全州艾滋病住院病例队列研究在马萨诸塞州 (1987).
- 包括40家医院的806次住院治疗.
- 分析了住院和30天死亡率,住院时间和重症监护室使用情况.
主要成果:
- 艾滋病经验较低的医院在住院患者死亡的相对风险是2.16倍.
- 在控制多个因素后,低艾滋病经验仍然是显著的预测因素 (RR 2.92).
- 缺乏经验的医院也显示了更长的住院时间和更高的ICU使用率.
结论:
- 艾滋病患者的死亡率在艾滋病经验较少的医院显著更高.
- 这种差异不能归因于患者严重程度,出院做法或资源强度的差异.
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