在患有痴呆症的人群中,在紧急部门访问后的家庭时间
Justine Seidenfeld1,2, Lindsay Zepel3, Valerie A Smith3,4,5
1Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, North Carolina.
JAMA network open
|February 3, 2026
概括
退伍军人患有痴呆症的急诊室 (ED) 访问对他们在家里的时间产生了重大影响. 接收决策和患者脆弱性和住房状况等因素是ED访问后长期住院的关键预测因素.
科学领域:
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
背景情况:
- 痴呆症患者的急诊室 (ED) 访问可以对他们的生活质量产生深远而持久的影响.
- 对此群体的ED护理下游结果的评估对于改善以患者为中心的护理至关重要.
- 家庭时间,定义为生活和机构护理之外的日子,为评估后ED结果提供了有价值的指标.
研究的目的:
- 调查退伍军人患有痴呆症在紧急诊所访问后在家时间的变化.
- 分析患者,设施和访问特征对家庭时间结果的影响.
- 在这个人口群体中,在ED遇到后,与减少家居时间相关的因素.
主要方法:
- 一项使用美国退伍军人事务部 (VA) 数据的国家回顾性队列研究.
- 在2017-2018财年包括65岁至110岁的退伍军人患有痴呆症,在2017-2018财年接受符合条件的VA ED访问.
- 使用负二项式模型分析家庭时间 (在ED访问后180天内不在家的日子).
主要成果:
- 这项研究分析了51707名患有痴呆症的退伍军人,揭示了ED访问后180天内平均21.7天不在家.
- 与出院相比,ED入院是不在家日数增加的最强预测因素 (RR, 3.18).
- 高脆弱性,无家可归状态,未婚状态和抑郁症等患者因素也与不在家的日数有显著的关联.
结论:
- 家庭时间作为一个以患者为中心的指标来评估急诊室对痴呆症患者的长期照顾的影响.
- 处置ED的决定显著影响访问后的结果,强调需要仔细考虑.
- 需要进一步的研究来完善家庭时间的应用,并优化痴呆症退伍军人的ED护理策略.
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