低收入老年人的老年护理管理:一个随机对照试验
Steven R Counsell1, Christopher M Callahan, Daniel O Clark
1Indiana University Center for Aging Research, Indiana University School of Medicine, Indianapolis, Indianapolis, IN 46202, USA. scounsel@iupui.edu
JAMA
|December 13, 2007
概括
基于家庭的老年人护理管理计划改善了生活质量,并减少了低收入老年人的急诊室访问. 该干预措施在与健康有关的生活质量方面显示出混合的结果,但在高风险患者中减少了急性护理的使用.
科学领域:
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
- 主要护理是指初级护理.
背景情况:
- 低收入的老年人往往有多种慢性疾病,不接受推的护理.
- 获得高质量的医疗保健是这一人口群体面临的重大挑战.
研究的目的:
- 评估老年护理管理模式的有效性.
- 提高初级保健机构中低收入老年人的护理质量.
主要方法:
- 一个受控的临床试验,涉及951名65岁以上的低收入成年人.
- 随机将患者分配到接受家庭护理管理的干预组或常规护理组.
- 干预包括2年的护理护士和社会工作者,与初级保健医生合作,并使用老年护理协议.
主要成果:
- 干预组在一般健康,活力,社会功能和心理健康方面显著改善 (SF-36得分).
- 在干预组中,急诊室的访问减少了 (每1000人中有1445人与1748人相比).
- 住院率没有显著差异,但在干预组中高风险患者的第二年,住院率较低.
结论:
- 综合的家庭老年护理管理提高了护理质量,并减少了高风险,低收入老年人急性护理的使用.
- 与健康有关的生活质量改善是混合的,身体功能在各组之间没有差异.
- 需要进一步的研究来优化准和评估减少急性护理利用的成本效益.
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