Half Of Older Americans Seen In Emergency Department In Last Month Of Life; Most Admitted To Hospital, And Many Die There
Half Of Older Americans Seen In Emergency Department In Last Month Of Life; Most Admitted To Hospital, And Many Die There
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DOI：
10.1377/hlthaff.2011.0922
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发表时间：
2012-06-01
期刊：
影响因子：
9.7
通讯作者：
Covinsky, Kenneth
中科院分区：
文献类型：
--
作者：
Smith, Alexander K.;McCarthy, Ellen;Covinsky, Kenneth
急诊科的使用增加了生命末期的费用，对病人和家庭成员来说是潜在的负担。我们调查了1992-2006年期间65岁或以上的老年人纵向研究中死亡的患者在生命最后几个月的急诊科使用情况。我们发现，在4518名死者中，51%的人在生命的最后一个月去过急诊室，75%的人在生命的最后六个月去过急诊室。重复访问很常见。在生命的最后一个月里，急诊科共有77%的病人被送进了医院，其中68%的人在那里死亡。相比之下，在临终前至少一个月接受临终关怀的病人在生命的最后一个月很少去急诊室。鼓励病人和家属为死亡做好准备和尽早登记安宁疗护的政策，可能会阻止病人在生命结束时到急诊科就诊。
Emergency department use contributes to high end-of-life costs and is potentially burdensome for patients and family members. We examined emergency department use in the last months of life for patients age sixty-five or older who died while enrolled in a longitudinal study of older adults in the period 1992-2006. We found that 51 percent of the 4,518 decedents visited the emergency department in the last month of life, and 75 percent in the last six months of life. Repeat visits were common. A total of 77 percent of the patients seen in the emergency department in the last month of life were admitted to the hospital, and 68 percent of those who were admitted died there. In contrast, patients who enrolled in hospice at least one month before death rarely visited the emergency department in the last month of life. Policies that encourage the preparation of patients and families for death and early enrollment in hospice may prevent emergency department visits at the end of life.