老年家庭护理客户的省际变化及其途径:加拿大的基于人口的回顾性队列研究
Lori Mitchell1, Jeffrey Poss2, Martha MacDonald3
1Shared Health Manitoba, Winnipeg, MB, Canada. lmitchell3@sharedhealthmb.ca.
BMC geriatrics
|June 26, 2023
概括
加拿大的公共资助的家庭护理有所不同,影响了老年人的护理途径. 在过去的四年中,许多客户从家庭护理转型,突出了更好的社区支持规划的需要.
科学领域:
- 老年学和卫生服务研究研究
- 对老龄化人口的医疗保健提供模式的分析.
背景情况:
- 加拿大的公共资助的家庭护理计划旨在支持老年人在家中老龄化.
- 在不同的家庭护理计划中,在服务提供和交付方面存在显著差异.
- 了解客户路径对于优化家庭护理系统有效性至关重要.
研究的目的:
- 调查不同的家庭护理方法如何影响老年成人客户的护理轨迹.
- 分析客户的途径,包括改善,长期护理 (LTC) 放置或死亡,在家庭护理系统内.
- 在四年内确定与特定客户途径和结果相关的因素.
主要方法:
- 追溯分析将家庭护理评估数据 (RAI-HC) 与卫生行政数据联系起来.
- 在2011-2013年期间,纳入了新斯科舍省卫生 (NSH) 和温尼伯地区卫生局 (WRHA) 接受家庭护理的60岁以上的客户.
- 客户特征,服务使用和跨司法管辖区和排放流中的排放途径的统计比较 (t-test,chi-square).
主要成果:
- 新斯科舍省 (NS) 的客户表现出更高的基线需求 (ADL,认知障碍),并且与温尼伯地区卫生局 (WRHA) 客户相比,更频繁地被送往长期护理 (LTC) (43%对38%).
- 护理人员的痛苦被确定为与退院LTC相关的一个因素.
- 四年后,超过一半的客户不再在社区中,在两年左右的时间里,LTC或死亡发生.
结论:
- 在家庭护理系统内外的客户途径受司法管辖的方法和客户特征的影响.
- 很大一部分老年人在相对较短的时间内经历过家庭护理的过渡 (约. 2年) 的时间.
- 有证据支持需要积极识别有风险的客户,并加强社区护理规划,以支持持续的老龄化.
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