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评估一个移动的综合健康过渡期护理计划,以减少再接收:从一个准实验设计的发现.

Laurel O'Connor1, Stephanie Denise M Sison2, Kimberly Eisenstock3

  • 1Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.

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概括

护理人员领导的移动综合健康 (MIH) 计划,就像PACED干预一样,大大减少了退院后老年人的30天再住院时间. 这种方法支持现场老龄化,并改善过渡期护理结果.

关键词:
社区护理医生社区护理医生紧急医疗服务 紧急医疗服务移动综合健康服务在急性病后的护理.过渡性护理是指过渡性护理.

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科学领域:

  • 老年学是一门学科.
  • 医疗保健服务研究 医疗服务研究
  • 移动综合健康服务

背景情况:

  • 退院对于老年人来说是一个脆弱的时期,增加了医疗,功能和社会衰退的风险.
  • 移动综合卫生 (MIH) 计划为过渡期护理差距提供了潜在的解决方案.
  • 对于虚弱的老年人出院后护理中MIH的有效性需要进一步评估.

研究的目的:

  • 评估护理人员辅助社区评估 (退院后) 干预 (PACED) 对30天再住院率的影响.
  • 评估PACED干预和30天急诊室 (ED) 使用之间的关联.
  • 调查MIH在医院住院后过渡期间支持脆弱的老年人中的作用.

主要方法:

  • 采用了前性观察性研究设计.
  • 从城市学术医疗中心出院的老年人得到了护理人员在72小时内进行的家庭访问 (PACED干预).
  • 建立了一个比较组,使用居住在计划区域之外的患者,缺乏系统附属PCP或拒绝访问的患者;修改Poisson回归分析了结果.

主要成果:

  • 与比较组 (n=107,21.5%) 相比,PACED干预组 (n=190) 的30天再住院率显著降低 (12.6%).
  • 在PACED参与者中,重新住院的调整相对风险为0.45 (95% CI:0.26-0.77,p=0.003).
  • PACED参与者也经历了较少的30天ED访问 (11.5%对18.7%,调整后RR为0.58,p=0.05).

结论:

  • 像PACED这样的家庭MIH过渡期护理计划与脆弱老年人的30天再入院率降低有关.
  • 这些发现表明MIH是支持现场衰老的有价值模型.
  • MIH的干预表明了将其纳入老年友好型卫生系统的潜力.