通过家庭护理模式,COPD恶化住院后再入院的减少
Diana Sánchez-Mellado1, Felipe Villar-Álvarez1,2,3, Itziar Fernández Ormaechea1,2
1Pulmonology Department, IIS Fundación Jiménez Díaz, Madrid, Spain.
Open respiratory archives
|July 27, 2023
概括
慢性阻塞性肺病恶化 (COPDE) 的家庭护理模式显著减少了医院再入院,并改善了一年的生存率. 之前恶化的数量最能预测再接收风险.
科学领域:
- 肺部医学 肺部医学
- 医疗保健管理的管理
- 临床研究 临床研究
背景情况:
- 由于慢性阻塞性肺病恶化 (COPDE) 而重新入院,对医疗保健系统造成了重大负担.
- 需要有效的管理策略来降低再接收率并改善COPD患者的长期存活率.
研究的目的:
- 评估门诊慢性呼吸护理单位 (ACRCU) 家庭护理模式在减少COPDE的30日和90天住院再入院的有效性.
- 评估ACRCU模型对患者一年生存时间的影响.
- 为了验证回收风险尺度 (RRS) 以预测COPD回收.
主要方法:
- 一项观察性研究,采用前性数据收集和回顾性分析.
- 包括491名被诊断患有COPD的患者,因恶化需要住院治疗.
- 传统护理 (CC) 和由专业护士管理的ACRCU家庭护理 (HC) 计划之间的比较.
主要成果:
- 与传统护理相比,ACRCU家庭护理模式导致30天 (30.5%与50%相比) 和90天 (47.7%与65.2%) 的再入院率显著降低.
- 在ACRCU组中,一年生存率明显高于ACRCU组 (85.3%对59.1%).
- 再接收风险尺度 (RRS) 显示30日和90日再接收的预测能力有限 (AUC分别为0.69和0.66).
结论:
- 将恶化的或脆弱的COPD患者整合到ACRCU家庭护理模式中,可以减少再入院并改善生存率.
- 在入院前12个月的恶化发作数量是重新入院风险的最强预测指标.
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