急性脆弱性网络是否改善了老年人与脆弱性生活的结果? 一个分阶段的差异差异面板事件研究
Andrew Street1, Laia Maynou2,3,4, Simon Conroy5
1Department of Health Policy, The London School of Economics and Political Science, London, UK A.Street@lse.ac.uk.
BMJ quality & safety
|July 6, 2023
概括
急性脆弱性网络 (AFN) 并没有显著改善老年,脆弱患者的医院出院时间或健康结果. 为了实现AFN的目标,需要进一步开发干预和实施战略.
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
- 提高质量 提高科学 提高质量
背景情况:
- 虚弱的老年人对医疗保健系统构成重大负担,经常经历长时间住院和较差的健康结果.
- 需要有效的干预措施来支持脆弱的老年人从医院回家更快,更健康.
- 实施了急性脆弱性网络 (AFN),以改善对这一群体的护理.
研究的目的:
- 评估急性脆弱性网络 (AFN) 与常规护理相比的有效性.
- 确定AFN会员是否减少了脆弱老年患者的住院时间,住院死亡率,制度化和住院再接收.
主要方法:
- 采用了一个分阶差异面板事件研究设计.
- 该研究包括1,410,427名75岁以上的NHS患者,这些患者在2012年1月至2019年3月期间被录入英国医院,患有高脆弱风险.
- 干预站点 (66家医院) 连续加入了AFN,而248个控制站点提供了通常的护理.
主要成果:
- 在AFN站点和对照站点之间,在住院时间方面没有观察到统计学上显著的差异.
- 住院死亡率,制度化和住院再接收率也没有显示出AFN会员的显著改善.
- 对单个干预队伍的分析也没有显示出显著的影响.
结论:
- 目前形式的急性脆弱性网络没有证明对脆弱的老年患者的医院出院和健康结果有显著的益处.
- 调查结果表明,需要加强干预和实施战略,以提高AFN的有效性.
- 未来的努力应集中在为脆弱的老年人开发更强大,更有资源的质量改善协作方法上.
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