医院住院患者复杂性的基于人口的趋势
Hiten Naik1, Tyler M Murray1, Mayesha Khan1
1Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.
JAMA internal medicine
|January 8, 2024
概括
住院病人越来越复杂,急诊率更高,多病症和多药性. 在过去的15年中,释放后的风险,包括再入院和死亡率,也增加了.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床流行病学临床流行病学
- 人口健康 人口健康
背景情况:
- 临床观察表明,医院住院患者的复杂性越来越大.
- 之前的研究没有充分评估长期的这一趋势.
研究的目的:
- 评估医院住院患者复杂性在15年时间框架内的变化.
- 确定表明患者复杂性增加的具体措施.
主要方法:
- 一项为期15年的队列研究 (2002-2017年) 使用加拿大不列颠哥伦比亚省的行政卫生数据.
- 包括成人 (≥18岁) 非选择性住院病例,不包括与怀孕相关的诊断.
- 后勤回归分析用于评估复杂度指标的趋势.
主要成果:
- 在研究期末的住院患者更有可能通过急诊室入院,具有多病症和多药性.
- 增加了多种急性疾病的治疗和在医院经历不良事件的可能性.
- 减少了重症监护室停留和住院死亡的可能性,但增加了30天的无计划再入院和死亡风险.
结论:
- 大多数指标显示,医院住院患者的复杂性在15年内显著增加.
- 这些趋势需要在卫生系统规划和资源分配方面进行调整.
- 了解不断变化的患者复杂性对于有效的医疗保健服务至关重要.
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