一个多学科的医院在家计划在新加坡的三级医院:一项比较研究
Natalie Yingxian Ong1, Shirley Xin Jin Chu2, Milawaty Nurjono2
1Department of Acute and Rehabilitative Care at Home (ARCH), Changi General Hospital, Singapore, Singapore. natalie.ong.yingxian@singhealth.com.sg.
Journal of general internal medicine
|November 1, 2025
概括
新加坡的家庭医院 (HaH) 护理减少了住院时间,但没有增加死亡率或成本. 虽然再入院情况相似,但HaH患者在出院后访问急诊室的次数更多,这表明需要改善后续监测.
科学领域:
- 提供医疗保健的模式.
- 急性护理创新的创新
- 比较有效性研究比较有效性研究
背景情况:
- 在家医院 (HaH) 在患者住所提供急性护理,这是西方国家建立的模式.
- 亚洲的医疗保健系统面临着独特的挑战,需要对亚洲地区的高血压影响进行评估.
研究的目的:
- 为了比较医院在家 (HaH) 护理的有效性和安全性与传统的住院护理.
- 评估结果,包括停留时间,死亡率,成本和出院后的利用率在亚洲第三级医院环境中.
主要方法:
- 追溯分析比较了143名HaH患者与147名接受常规住院护理的对照患者.
- 测量结果:住院和总住院时间 (LOS),死亡率,费用,30日和90日再入院,以及急诊室 (ED) 访问.
主要成果:
- 哈赫患者在住院期间的LOS显著较短 (-40%,5天),但总LOS较长 (+28%,2天).
- 在死亡率,30日或90日再入院或30日急救诊所访问方面没有发现显著差异.
- HaH患者在出院后90天内使用ED的可能性更高;成本相似.
结论:
- 在亚洲的第三级医院环境中,在家庭医院的医院护理是可行的,证明了较短的住院LOS与可比的死亡率和成本.
- 调查结果支持在类似的亚洲医疗保健环境中采用HAH,强调需要强有力的出院后支持来管理ED使用情况.
- 证据指导政策制定者有效地整合家庭急性护理模式.
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