Potentially avoidable hospitalizations, non-potentially avoidable hospitalizations and in-hospital deaths among residents of long-term care facilities
Potentially avoidable hospitalizations, non-potentially avoidable hospitalizations and in-hospital deaths among residents of long-term care facilities
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DOI：
10.1111/ggi.13458
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发表时间：
2018-08-01
影响因子：
3.3
通讯作者：
Ishizaki, Tatsuro
中科院分区：
文献类型：
--
作者：
Jeon, Boyoung;Tamiya, Nanako;Ishizaki, Tatsuro
AimThe本研究的目的是检查的百分比和危险因素的潜在可避免的住院（PAH），非PAH和住院死亡的特殊养老院的老年人（SNH）和老年健康服务设施（GHSF）的居民之间的长期护理和国民健康保险索赔数据（2012年4月至2013年9月），从郊区城市千叶县，日本。研究参与者年龄75岁，居住在SNH（n = 1138）或GHSF（n = 885）。PAH的定义使用17个医疗条件组，并确定PAH，非PAH和院内死亡的百分比，并使用SNH和GHSF的多水平logistic回归模型分别比较相关因素。（16.3%）、非PAH（12.2%）或院内死亡（6.1%）。在GHSF居民中，23.8%经历了住院治疗，包括PAH（9.5%）、非PAH（10.6%）和院内死亡（3.7%）。超过70%的肺动脉高压与呼吸道感染、尿路感染或充血性心力衰竭有关。在SNH和GHSF中，人工营养与多环芳烃和非多环芳烃呈正相关，男性与非多环芳烃和住院死亡呈正相关。然而，也有SNH和GHSF的PAH的危险因素方面的差异。结论PAH的百分比在SNH高于GHSF，这可能与不同的人员和管理法规。健康和长期护理索赔数据之间的联系可能会促进基于数据的决策证据。Geriatr Gerontol Int 2018; 18：1272-1279.
AimThe present study aimed to examine the percentage of and risk factors for potentially avoidable hospitalizations (PAH), non-PAH and in-hospital deaths among residents of special nursing homes for the elderly (SNH) and geriatric health service facilities (GHSF).MethodsLong-term care and national health insurance claims data (April 2012 to September 2013) were obtained from a suburban city in Chiba prefecture, Japan. Study participants were aged 75 years and resided in either SNH (n = 1138) or GHSF (n = 885). The PAH were defined using 17 medical condition groups, and the percentage of PAH, non-PAH and in-hospital deaths was identified, and associated factors were compared using multilevel logistic regression models for SNH and GHSF, respectively.ResultsA total of 34.5% SNH residents experienced any hospitalization, and this was composed of PAH (16.3%), non-PAH (12.2%) or in-hospital deaths (6.1%). Of the GHSF residents, 23.8% experienced any hospitalization, and this was comprised of PAH (9.5%), non-PAH (10.6%) and in-hospital death (3.7%). More than 70% of the PAH were related to respiratory infections, urinary tract infections or congestive heart failure. In both SNH and GHSF, artificial nutrition was positively associated with PAH and non-PAHs, and male sex was positively associated with non-PAHs and in-hospital deaths. However, there were also discrepancies between SNH and GHSF in terms of risk factors for PAH.ConclusionsThe percentage of PAH was higher in SNH than in GHSF, which might be related to their different personnel and managerial regulations. The linkage of health and long-term care claims data might facilitate data-based evidence on policy-making. Geriatr Gerontol Int 2018; 18: 1272-1279.