预先进行护理规划和实体瘤瘤科住院患者的医院结果
Denis Qeska1, Ronald Chow1, Tracy A Balboni2
1Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
BMJ supportive & palliative care
|July 27, 2023
概括
癌症患者的预先护理计划 (ACP) 文档与更少的医院再入院和急诊室 (ED) 访问有关. 这一发现无论临终关怀如何,都适用,这表明患者的治疗结果有所改善.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 抚慰性护理是一种缓解性护理.
背景情况:
- 提前护理计划 (ACP) 对癌症患者至关重要,但它对特定医疗保健利用结果的影响需要进一步研究.
- 了解记录的ACP与死亡率,再接收和急诊室 (ED) 访问等结果之间的关联对于改善癌症护理至关重要.
- 以前的研究还没有完全阐明ACP对这些关键患者结果的独立影响.
研究的目的:
- 评估记录的预先护理计划 (ACP) 与癌症患者的关键结果之间的关系.
- 具体来说,要评估ACP与住院死亡率,30天住院再入院和30天急救诊所访问的关联.
- 确定非洲和非洲国家/地区的文档是否独立地影响这些利用指标.
主要方法:
- 一项观察性队列研究使用了来自耶鲁纽黑文医院的数据.
- 该研究包括2018年1月1日至2021年12月31日期间入院的患有固体瘤恶性病的患者.
- 使用多变量后勤回归分析了ACP与结果之间的关联,并根据相关的共变量进行调整.
主要成果:
- 在19422名癌症患者中,6.6%的人有记录的ACP.
- 患有ACP的患者通常年龄较大,并且具有较长停留时间和重症监护室入院等特征.
- 独立地,ACP与30天再接收 (OR=0.70) 和30天ED访问 (OR=0.79) 的显著减少有关.
结论:
- 记录的预先护理计划 (ACP) 与癌症患者重新入院和急诊室访问的减少有关.
- 即使考虑到住院死亡率和患者特征,这种关联仍然存在.
- 非洲国家和地区的文档似乎是优化医疗保健在瘤治疗中的利用的一个有价值的工具.
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