瘤医院医师对临终关怀利用率的影响
Elizabeth Prsic1, Jensa C Morris2,3, Kerin B Adelson1,4
1Section of Medical Oncology, Yale School of Medicine, New Haven, Connecticut, USA.
Cancer
|September 14, 2023
概括
瘤医院医生显著增加了晚期癌症患者的临终关怀过渡,促进了早期获得终身护理的机会. 这种转变导致在宿舍转诊之前住院时间更短,改善了患者的治疗结果.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 晚期癌症患者的意外住院往往会引发终身护理讨论和临终关怀过渡.
- 迟到的临终关怀转诊与生活质量下降和医疗保健成本增加有关.
- 住院瘤治疗越来越多地由医院医生管理,但它们对宿舍时间的影响尚不清楚.
研究的目的:
- 为了比较内部医学培训的医院医生领导的和瘤学家领导的住院瘤服务之间的临终关怀出院率和出院时间.
- 评估瘤医院医生对晚期癌症患者住院利用的影响.
主要方法:
- 斯米洛癌症医院的一项比较研究,将医院医师领导的服务 (HS) 与传统的瘤学家领导的服务 (TS) 相比较.
- 使用电子医疗记录分析2021年7月至2022年1月的出院数据.
- 使用后勤和多变量线性回归模型来评估出院处置和调整停留时间的几率比率.
主要成果:
- 医院医师领导的服务 (HS) 将11.8%的患者送往住院治疗,而传统服务 (TS) 的比例为5.8%,调整后的几率比率为1.94 (p=0.03).
- 住院患者退院前住院的平均时间在HS (6.83天) 与TS (16.29天) (p=0.003) 之间明显较短 (p=0.003).
结论:
- 瘤医院医生提高了临终关怀的利用率,并加快了住院患者的临终关怀转诊.
- 将医院医生整合到住院瘤服务中可以改善晚期癌症患者住院过渡的时间.
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