在英国一般实践中对老年人的基于人口的多维评估:一个集群随机的因数试验
Astrid E Fletcher1, Gill M Price, Edmond S W Ng
1Centre for Ageing and Public Health, London School of Hygiene and Tropical Medicine, London, UK. astrid.fletcher@lshtm.ac.uk
Lancet (London, England)
|November 9, 2004
概括
对老年人的多维评估和管理对死亡率或住院患者的影响很小. 然而,通用评估方法改善了家庭护理中的生活质量,而老年人团队管理改善了社会互动.
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:
- 对老年人的综合多维评估和管理的有效性进行了辩论.
- 现有研究受到小试验规模的限制,阻碍了政策决策.
- 本研究旨在评估老年人群的不同评估和管理策略.
研究的目的:
- 在老年人中,比较通用与有针对性的多维评估的影响.
- 评估老年医疗团队与初级保健团队管理对患者结果的影响.
- 确定这些方法对死亡率,住院和生活质量的影响.
主要方法:
- 一个集群随机因子试验,涉及106名全科医生和43,219名75岁以上的患者.
- 普遍的评估 (护士为所有人进行深入评估) 与有针对性的评估 (对那些发现问题的人进行评估) 的比较.
- 医院老年医疗团队与初级保健团队管理的比较.
主要成果:
- 两组之间没有观察到死亡率或住院/机构入院的显著差异.
- 全面评估导致了家庭护理生活质量的改善.
- 老年人团队管理显示出移动性,社交互动和士气的改善,社交互动是一个一致的发现.
结论:
- 不同形式的多维评估表明患者整体结果的差异可以忽略不计.
- 虽然生活质量有所改善,但对死亡率和住院患者的影响很小.
- 研究结果表明,所选择的评估和管理策略对老年人主要健康结果的影响有限.
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