Interface between residential aged care facilities and a teaching hospital emergency department in Western Australia
Interface between residential aged care facilities and a teaching hospital emergency department in Western Australia
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DOI：
10.5694/j.1326-5377.2006.tb00313.x
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发表时间：
2006-05-01
影响因子：
11.4
通讯作者：
Sprivulis, Peter
中科院分区：
文献类型：
--
作者：
Finn, Judith C.;Flicker, Leon;Sprivulis, Peter
目的：估计适当的急诊科（艾德）介绍年龄>= 65岁的人住在住宅护理facility.Design，设置和参与者：回顾性队列研究的老年居民的住宅护理设施谁提出的皇家珀斯医院，西澳大利亚州，2002年1月至6月之间的艾德。数据由一个专家临床小组进行审查。主要结果指标：艾德表现的适当性，提出投诉，在转移前全科医生/临时医生的参与，从艾德入院的患者比例，出院生存率。541名年龄≥ 65岁的居民被救护车转移到艾德，占该年龄组所有艾德就诊者的8.3%。研究队列的平均年龄为83.7岁（SD，7.0岁），其中68%为女性。在541例病例中，326例（60%）导致住院，其中276例（85%）存活至出院。肌肉骨骼疾病占所有表现的25%，22%与跌倒有关;肺炎（占表现的11%）是最大的单一表现投诉。艾德出席被认为是“不适当的”71/541例（13.1%; 95% CI，10.5%-16.2%）;只有25%的艾德在转院前有全科医生/临时医生参与。大多数老年护理居民的艾德演讲被认为是适当的，但在协调医院艾德和住宿护理机构之间的护理方面仍有改进的余地。
Objective: To estimate the appropriateness of emergency department (ED) presentations by people aged >= 65 years living in residential care facilities.Design, setting and participants: Retrospective cohort study of older residents of residential care facilities who presented to the ED of the Royal Perth Hospital, Western Australia, between January and June 2002. Data were reviewed by an expert clinical panel.Main outcome measures: Appropriateness of ED presentation, presenting complaint, involvement of a general practitioner/locum doctor prior to transfer, proportion of patients admitted to hospital from the ED, survival to discharge.Results: 541 residents aged >= 65 years were transferred by ambulance to the ED, comprising 8.3% of all ED presentations of people in this age group. The mean age of the study cohort was 83.7 years (SD, 7.0 years), of which 68% were women. Of the 541 presentations, 326 (60%) resulted in hospital admission, and of these, 276 (85%) survived to hospital discharge. Musculoskeletal disorders accounted for 25% of all presentations, and 22% were falls-related; pneumonia (11% of presentations) was the single largest presenting complaint. ED attendance was deemed "inappropriate" for 71/541 cases (13.1%; 95% CI, 10.5%-16.2%); in only 25% of ED presentations was a GP/locum doctor involved prior to transfer.Conclusions: The majority of ED presentations by aged care residents were considered to be appropriate, but there was scope for improvement in coordinating care between the hospital ED and residential care institutions.