The use of acute hospital services by elderly residents of nursing and residential care homes
The use of acute hospital services by elderly residents of nursing and residential care homes
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DOI：
10.1046/j.1365-2524.2001.00314.x
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发表时间：
2001-11-01
影响因子：
2.4
通讯作者：
Pollock, AM
中科院分区：
文献类型：
--
作者：
Godden, S;Pollock, AM
本研究的目的是比较疗养院和住宿护理院居民与社区居民的入院原因、医院死亡率和住院时间。这是一项对 1996 年 4 月至 1997 年 3 月期间默顿、萨顿和旺兹沃斯一个卫生区的急性医院紧急入院情况的回顾性研究。通过数据链接和手动查找来得出 65 岁及以上疗养院居民的紧急入院情况。根据护理院和具有相对风险的社区居民的原因、住院时间和医院死亡情况计算入院率。与社区相比，从护理院紧急入院的相对风险为：所有诊断的相对风险为 1.39，所有损伤的相对风险为 2.68，股骨颈骨折的相对风险为 3.96。疗养院居民在医院死亡的相对风险总体为 2.58，住院前 48 小时内为 3.64（P 值 < 0.0001）。住宅区的入院率高于疗养院。假期期间和圣诞节期间，家庭入场人数有所增加。总之，由于记录质量差和 NHS 编码不准确，监测疗养院和住宿护理院的入院情况存在重大困难。由于缺乏有关养老院居民年龄、性别概况以及医疗保健需求的数据，情况变得更加复杂。需要进行前瞻性研究以确定何时可以避免入院以及何时适当。信息战略需要确保常规数据源能够监测疗养院居民对医院服务的使用情况。
The objective of this study was to compare hospitalisation rates by cause of admission, hospital death rates and length of stay for residents from nursing and residential care homes with those in the community. This is a retrospective study of acute hospital emergency admissions in one health district, Merton, Sutton and Wandsworth between April 1996 and March 1997. Data linkage and manual look up were used to derive emergency hospital admissions for residents of care homes aged 65 and over. Admission rates were calculated for cause, length of stay and hospital death for residents of care homes and in the community with relative risks. The relative risk of emergency admission from a care home compared with the community was 1.39 for all diagnoses, 2.68 for all injuries, and 3.96 for fracture of neck of femur. The relative risk of dying in hospital for care home residents was 2.58 overall, and 3.64 in the first 48 hours of a hospital stay (an P-values < 0.0001). Admission rates were higher from residential than from nursing homes. There was some increase in admissions from homes during holiday periods and over Christmas. In conclusion, there are major difficulties in monitoring admissions from nursing and residential care homes due to poor quality recording and inaccuracies in NHS coding. This was compounded by an absence of data on the age and sex profile and healthcare needs of the resident population in care homes. Prospective studies are required to ascertain when admission is avoidable and when it is appropriate. The information strategy needs to ensure that routine data sources are capable of monitoring the use of hospital services by residents of care homes.