最近的功能衰退和医院出院后的门诊随访:一个队列研究
Orly Bogler1, David Kirkwood2, Peter C Austin3,4
1Faculty of Medicine, University of Toronto, Toronto, Canada. orly.bogler@mail.utoronto.ca.
BMC geriatrics
|September 11, 2023
概括
最近的功能衰退并没有减少出院后7天的医生随访,即使是在COVID-19大流行期间. 功能性下降与COVID-19期间虚拟和家庭访问增加有关.
科学领域:
- 老年学是一门学科.
- 医疗保健服务研究 医疗服务研究
- 流行病学 流行病学
背景情况:
- 功能衰退是急性住院的常见后果,增加了再入院,制度化和死亡的风险.
- 早期医生随访对于过渡期护理至关重要,有可能防止功能衰退患者的不良结果.
- 随着COVID-19的蔓延,可能加剧了对那些经历功能衰退的个体获得退院后护理的挑战.
研究的目的:
- 调查最近功能衰退与出院后医生随访率之间的关联.
- 为了确定COVID-19大流行是否改变了这一关联.
- 评估功能衰退对及时获得出院后医疗护理的影响.
主要方法:
- 使用加拿大安大略省卫生行政数据进行的回顾性队列研究.
- 包括在2019年3月至2020年1月 (COVID-19前) 和2020年3月至2021年1月 (COVID-19) 期间从急性护理中出院的65岁以上患者.
- 倾向性评分权重用于比较具有和没有功能衰退的患者之间的医生随访7天内.
主要成果:
- 在COVID-19前 (45.0%对44.0%) 或COVID-19 (51.1%对49.4%) 期间,在患者和没有功能衰退的患者之间,在出院后7天的医生随访中没有显著差异.
- 功能衰退和7天随访之间的关联在两个时期都保持一致 (RR 1.02在COVID前,RR 1.03在COVID-19期间).
- 在COVID-19期间,功能衰退与7天的虚拟 (RR 1.15) 和家庭访问 (RR 1.64) 医生随访有关.
结论:
- 功能衰退与及时出院后医生随访率的降低无关.
- COVID-19大流行并没有对功能衰退患者的7天医生随访率产生负面影响.
- 在COVID-19大流行期间,功能衰退与虚拟和家庭医生随访服务的使用增加有关.
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