自然语言处理用于评估严重疾病的严重创伤的老年人的息护理过程和医疗保健利用情况
Daniel I Hoffman1,2, Sydney Moore1,3, Mengyuan Ruan1
1Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Journal of palliative medicine
|December 30, 2025
概括
老年创伤患者的息护理 (PC) 并没有减少医疗保健的使用,但增加了住院招生. 关键的PC流程,如护理目标对话,未得到充分利用,这表明需要改善护理的领域.
科学领域:
- 老年医学 老年医学
- 创伤外科 手术 创伤外科
- 抚慰性护理是一种缓解性护理.
背景情况:
- 国家指导方针主张在老年重创患者的生命维持治疗的同时提供息治疗 (PC).
- 在这个人群中PC的结果仍然不完全理解.
- 这项研究调查了PC文档的频率及其对出院后医疗保健利用的影响.
研究的目的:
- 评估严重创伤的老年人住院息护理 (PC) 过程文档的频率.
- 检查记录的PC流程与出院后医疗保健利用之间的关联.
- 确定改善老年严重创伤护理PC交付的领域.
主要方法:
- 使用电子健康记录和医疗保险索赔的回顾性队列研究.
- 包括在2016-2018年期间入院的66岁以上严重创伤的成年人.
- 自然语言处理 (NLP) 来识别五个关键PC流程的文档:代码状态,护理目标 (GOC) 对话,宿舍讨论,PC咨询和医疗代理.
主要成果:
- 在1267个招生中,81%至少有一个PC过程被记录在案. 平均年龄为82岁,中位数伤害严重程度得分为16.
- 在幸存者中,一年死亡率为26%. 没有发现PC过程文档与减少住院日,家庭日,急救诊所访问或ICU日之间有显著的关联.
- PC过程与一年内住院入院人数的增加显著相关 (p < 0.01).
结论:
- 患有严重创伤的老年人的息护理 (PC) 与整体医疗保健利用率的下降无关.
- PC 文档与在一年内更高的临终关怀入院率有关.
- 中国政府对话,专科PC和住院医院讨论的低利用率突出显示了改善医疗服务的关键领域.
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