风险因素与四级学术医院在家治疗计划中的护理升级相关
Jed Colt Cowdell1, Ellen Lopez2, Amy Haney2
1Division of Hospital Internal Medicine, Mayo Clinic Florida, Jacksonville, Florida, USA.
Journal of hospital medicine
|May 27, 2024
概括
家庭医院护理正在增长,但患者回归实体医院的升级需要研究. 已婚患者,有程序障碍和较高死亡风险的患者更有可能需要升级.
科学领域:
- 医疗保健提供 医疗保健提供
- 患者的治疗结果.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在家医院护理是住院住院的新兴模式.
- 护理的升级,或转移回实体医院,是医院在家计划的一个关键但未被充分研究的方面.
研究的目的:
- 为了确定与医院在家计划的护理升级相关的患者特定因素.
- 以医院在家模式为基础,为优化患者选择和护理管理策略提供信息.
主要方法:
- 在2022年1月至2022年12月的家庭高级护理 (ACH) 计划中对患者的回顾性审查.
- 从电子健康记录中收集人口统计,社会经济和临床数据.
- 分析导致主要结果的因素:护理升级.
主要成果:
- 在904名患者中,8.8%需要升级护理.
- 多变量分析显示,已婚患者 (HR:1.82) 和那些与程序相关疾病 (HR:2.61) 相关的患者的升级风险更高.
- 增加的死亡风险得分与更高的升级率显著相关 (每类别的HR增加1.86).
结论:
- 患者的婚姻状况,因手术相关疾病而入院以及死亡风险升高是医院在家护理升级的重要预测因素.
- 这些发现凸显了医院在家计划中需要仔细评估患者和量身定制的管理策略.
- 进一步的研究可以改进患者选择标准,以尽量减少不必要的升级,并改善护理协调.
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