Prospective study of the elder self-neglect and ED use in a community population
Prospective study of the elder self-neglect and ED use in a community population
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DOI：
10.1016/j.ajem.2011.02.008
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发表时间：
2012-05-01
影响因子：
3.6
通讯作者：
Evans, Denis
中科院分区：
文献类型：
--
作者：
Dong, XinQi;Simon, Melissa A.;Evans, Denis
目的：本研究的目的是量化老年人自我忽视和急诊利用率之间的关系在社区居住population.Methods：一个前瞻性的基于人口的研究是在一个地理定义的社区在芝加哥社区居住的老年人谁参加了芝加哥健康与老龄化项目。在芝加哥健康与老龄化项目的6864名参与者中，有1165名参与者因怀疑老年人自我忽视而向社会服务机构报告。主要预测因子是向社会服务机构报告的老年自我忽视。研究结果是从医疗保险和医疗补助服务中心获得的急诊科年利用率。Poisson回归模型被用来评估这些纵向relations.Results：平均每年的急诊就诊率为那些没有老年自我忽视的人是0.6（1.3），和那些报告老年自我忽视，这是1.9（3.4）。在调整社会人口统计学，社会经济变量，医疗条件，认知和身体功能后，自我忽视的老年人有显着更高的急诊利用率（率比，1.42; 95%置信区间，1.29-1.58）。自我忽视严重程度更高（轻度：标准化参数估计值[PE]，0.27;标准误[SE]，0.04; P < .001;中度：PE，0.41; SE，0.03; P < .001;重度：PE，0.55; SE，0.09; P <0.001）与急诊使用率的增加相关。结论：老年人自我忽视与该社区人群急诊利用率的增加有关。更大的自我忽视的严重程度与急诊室利用率的增加有关。(C)2012 Elsevier Inc. All rights reserved.
Purpose: This study aims to quantify the relation between elder self-neglect and rate of emergency department utilization in a community-dwelling population.Methods: A prospective population-based study is conducted in a geographically defined community in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project. Of the 6864 participants in the Chicago Health and Aging Project, 1165 participants were reported to social services agency for suspected elder self-neglect. The primary predictor was elder self-neglect reported to social services agency. The outcome of interest was the annual rate of emergency department utilization obtained from the Center for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships.Results: The average annual rate of emergency department visits for those without elder self-neglect was 0.6 (1.3), and for those with reported elder self-neglect, it was 1.9 (3.4). After adjusting for sociodemographics, socioeconomic variables, medical conditions, and cognitive and physical function, older people who self-neglect had significantly higher rates of emergency department utilization (rate ratio, 1.42; 95% confidence interval, 1.29-1.58). Greater self-neglect severity (mild: standardized parameter estimate [PE], 0.27; standard error [SE], 0.04; P < .001; moderate: PE, 0.41; SE, 0.03; P < .001; severe: PE, 0.55; SE, 0.09; P < .001) was associated with increased rates of emergency department utilization, after considering the same confounders.Conclusion: Elder self-neglect was associated with increased rates of emergency department utilization in this community population. Greater self-neglect severity was associated with a greater increase in the rate of emergency department utilization. (C) 2012 Elsevier Inc. All rights reserved.