在入住养老院之前和之后的住院:一个中断的时间序列分析
Karla Seaman1, Guogui Huang1, Nasir Wabe1
1Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
Australasian journal on ageing
|October 20, 2023
概括
住院养老机构 (RACF) 的住院住院率在入院后显著下降,而长期居民的住院率仍在下降. 这表明多次入院可能会在RACF入院之前发生,突出显示需要有效的社区护理策略.
科学领域:
- 老年学是指老年学的学科.
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
背景情况:
- 住院是住院老年护理设施 (RACF) 护理质量的关键指标.
- 了解RACF入伍前后的医院使用模式对于改善居民安全和护理至关重要.
- 常规收集的数据为分析老年护理中的医疗保健利用提供了宝贵的资源.
研究的目的:
- 检查RACF入院前12个月和入院后12个月住院率的变化.
- 调查与RACF入院相关的所有原因和跌倒相关住院的趋势.
- 评估这些趋势是否因性别或痴呆症状况而有所不同.
主要方法:
- 使用了追溯纵向队列研究设计.
- 分析了25个澳大利亚RACF的1029名居民的老年护理提供者和医院记录数据.
- 用细分回归的中断时间序列分析来建模住院率随时间的变化.
主要成果:
- 在RACF加入之前的12个月里,全因住院率急剧上升,达到每月1000名居民中303人.
- 在RACF入院后,住院率大幅下降至每1000名居民中的55人,并保持稳定.
- 在与秋季相关的住院病例中观察到类似的模式,在性别和痴呆症状态之间一致.
结论:
- 进入RACF与住院率大幅持续下降有关.
- 这些发现表明,频繁入院可能是进入住院养老院的先驱.
- 需要进一步研究以社区为基础的服务,以有效地减少在RACF入院之前不断升级的住院.
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