家庭健康和安全干预对脆弱老年人的急诊室使用的影响:一项前性观察研究
Sandy Bogucki1, Gina Siddiqui2, Ryan Carter3
1Yale School of Medicine, Department of Emergency Medicine, New Haven, Connecticut.
The western journal of emergency medicine
|June 6, 2023
概括
一个家庭健康计划减少了急诊室 (ED) 使用老年人摔倒和访问ED. 自称有跌倒风险的老年人没有从这项干预中获得类似的好处.
科学领域:
- 老年医学 老年医学
- 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:
- 老年患者面临独立性风险,包括虚弱,认知衰退,移动性问题和跌倒.
- 紧急部门 (ED) 的利用是这个人口的一个重大问题.
- 多学科干预旨在减轻这些风险并改善健康结果.
研究的目的:
- 评估协调的家庭健康计划对老年患者所有原因的ED利用的影响.
- 评估该计划在不同脆弱性和跌倒风险分层路径中的有效性.
- 确定脆弱性评估和社区资源协调是否减少了短期的ED访问.
主要方法:
- 有三个招生途径的前性观察研究:与跌倒相关的ED访问,跌倒风险的自我转诊和9-1-1升降器辅助.
- 干预涉及护理人员和护士对家庭进行家庭访问,以评估脆弱性/安全性和资源协调.
- 结果将干预组与拒绝干预的对照组进行了比较,测量了30天,60天和90天的ED利用率.
主要成果:
- 与对照组相比,通过与秋季相关的ED访问招募的受试者在30,60和90天后的ED遭遇明显较低 (所有人P<0.001).
- 自助推组的参与者在干预后与对照组相比,在ED遭遇方面没有显著差异 (P>0.23).
- 9-1-1提升辅助小组太小,无法进行可靠的统计分析.
结论:
- 需要ED评估的跌倒是脆弱的潜在指标.
- 在ED秋季访问后的协调社区干预有效地减少了随后的任何原因的ED使用.
- 自我识别的跌倒风险本身并没有预测这种特定的家庭健康干预措施的显著益处.
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