美国州立POLST计划的成熟状态和在美国养老院或临终关怀中死亡:一个事件时间研究
Komal Patel Murali1, May Hua2, Patricia W Stone3
1Rory Meyers College of Nursing, New York University, New York, NY, USA; Center for Health Policy, Columbia University School of Nursing, New York, NY, USA.
Journal of the American Medical Directors Association
|February 20, 2026
概括
医生订单维持生命治疗 (POLST) 计划的成熟度增加了养老院居民在现场或临终关怀中死亡的可能性. 这支持符合目标的终身护理,并减少了医院转移.
科学领域:
- 老年学是一门学科.
- 抚慰性护理是一种缓解性护理.
- 医疗服务研究 医疗服务研究
背景情况:
- 医生订单维持生命治疗 (POLST) 计划旨在记录生命终端护理偏好.
- 国家POLST计划通过开发和认可阶段成熟.
- 了解计划成熟度对死亡地点的影响对于终身护理计划至关重要.
研究的目的:
- 检查国家POLST计划成熟度与养老院居民死亡地点之间的关联.
- 确定POLST的实施是否会影响居民死亡的地点,特别是养老院或宿舍与其他地方.
主要方法:
- 一项事件时间研究分析了美国65岁以上养老院居民的10%随机样本,这些居民在2012-2018年间死亡.
- 居民死亡数据与国家POLST计划开发和认可年份进行了合并.
- 一个线性概率模型评估了在养老院或临终关怀中心与其他地点死亡的可能性.
主要成果:
- 随着POLST计划的发展,在养老院或宿舍死亡的概率在第一年增加了1.6个百分点,五年后增加了5.6个百分点.
- 在POLST计划批准后,在现场死亡的可能性持续增加.
- 这项研究包括225,149名养老院居民,其中74.3%患有阿尔茨海默氏症或痴呆症.
结论:
- 波尔斯特计划的成熟度与养老院居民在现场或临终关怀中死亡的可能性更高有关.
- 这种联系表明,成熟的POLST计划可能会支持符合目标的终身护理.
- 死亡在现场的可能性增加,可能会减少临近生命终点的居民负担重重的医院转移.
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