我们的病人是否变得越来越复杂? 在通用医学中并发症和功能依赖的趋势 2011-2019年
Stephanie J Snedden1, Paul Thein1, Wee J Chee1
1Department of General Medicine, Monash Medical Centre, Melbourne, Victoria, Australia.
Internal medicine journal
|September 11, 2024
概括
一般医学中的患者复杂性似乎正在增加,这是由于患者的依赖性日益增加,而不是慢性疾病负担. 这项研究使用客观措施追踪了9年来患者复杂性趋势.
科学领域:
- 老年病的医生 老年病的医生
- 内部医学 内部医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 事观察表明,尽管疾病严重程度没有明显增加,但一般医学患者的复杂性越来越高.
- 这项研究旨在客观地评估患者复杂性的趋势随着时间的推移.
研究的目的:
- 客观地测量9年内通用医学患者复杂性的趋势.
- 调查伴随性疾病或依赖性/脆弱性的变化是否有助于患者复杂性的感知增加.
主要方法:
- 复杂性的实用定义结合了并发症和依赖/脆弱性.
- 从2011年至2019年,每年连续100名通用医学患者被分析.
- 查尔森并发症指数 (CCI),卡茨日常生活活动独立指数 (Katz ADL) 和布雷登尺度 (BS) 用于评估并发症和依赖/脆弱性.
主要成果:
- 在查尔森并发症指数 (CCI) 或卡茨日常生活活动独立指数 (Katz ADL) 中没有观察到统计学意义上的变化.
- 布拉登尺度 (BS) 中位数的得分从2011年的19分大幅下降到2019年的16分 (P = 0.006).
- 降低BS分数表明压力损伤的风险增加,这表明患者的依赖性正在增加.
结论:
- 尽管并发症水平稳定,但布拉登尺度 (BS) 评分下降表明患者依赖性增加.
- 患者复杂性的明显增加可能归因于不断增长的依赖性,而不是慢性疾病负担的变化.
- 客观测量对于理解一般医学中不断变化的患者特征至关重要.
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