内部医学中的可持续性:为期一年的病房范围的观察性研究
Giuseppe A Ramirez1,2,3, Sarah Damanti2,3, Pier Francesco Caruso2,3
1Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy.
医疗保健援助和医生人数显著影响医院患者的结果和可持续性,不仅仅是患者的健康状况. 了解这些因素是改善医疗保健系统的关键.
科学领域:
- 内部医学 内部医学
- 医疗保健管理的管理
- 公共卫生 公共卫生
背景情况:
- 人口老龄化和多重疾病对医疗保健系统的可持续性构成重大挑战.
- 与协助相关的变量对患者结果的影响,独立于个体病理生理学,需要进一步研究.
研究的目的:
- 确定可持续医院医疗保健的与援助相关的决定因素.
- 分析患者病情以外的因素如何影响住院死亡率,住院时间和医院感染.
主要方法:
- 对1073名内科病人的前性观察性研究,分为培训 (n=726) 和验证 (n=347) 的子集.
- 分析人口统计,并发症 (使用累积疾病评分表 - CIRS),护理强度 (人力资源分数的九个等价值 - NEMS) 和医疗保健人员变化.
- 包括来源设置,日常生活依赖活动和感染状态作为变量.
主要成果:
- 较高的死亡率与晚年相关,较高的CIRS严重性指数 (CIRS-SI),末期癌症和缺乏免疫媒介疾病.
- 与护理院/ICU入院,日常生活依赖,感染,氧气支持,患者/医生比例和患者退院相关的长时间住院.
- 与上部胃肠道疾病,晚年和较高CIRS-SI相关的鼻腔感染.
结论:
- 人口统计学变量和多病症很重要,但医生人数和援助环境也显著影响住院结果.
- 这些发现凸显了需要考虑可持续医院医疗保健的运营和人员因素的必要性.
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