Trends in the hospital care of acute childhood asthma 1970-8: a regional study.
Trends in the hospital care of acute childhood asthma 1970-8: a regional study.
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1970 年 8 月急性儿童哮喘医院护理趋势：一项区域研究。
DOI：
10.1136/bmj.281.6249.1191
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发表时间：
1980
影响因子：
--
通讯作者：
S. West
中科院分区：
文献类型：
--
作者：
H. Anderson;P. Bailey;S. West
在泰晤士河西南部地区，1970-2008年期间，5-14岁儿童因哮喘入院的人数从256人增加到684人，增加了167%。通过对该地区各医院1970年和1978年的常规医院统计数据的分析和病例记录的检查，调查了与这一趋势有关的因素。这一趋势的部分原因是重新入院率的增加。自我转介的患者增加了五倍多；这些患者入院时哮喘不那么严重，再住院率高于全科医生转介的患者。在这九年中，入院前后的药物管理发生了很大的变化，医院的调查也是如此。总体而言，入院时的严重程度几乎没有变化。入院人数的增加与该区域哮喘死亡人数的减少无关，尽管在哮喘的药物控制方面取得了重大进展，但仍出现了这种情况；这表明门诊护理不足。护理平衡向医院的转移和医院越来越多地采用初级保健职能表明，医院和全科医生需要共同商定急性哮喘的管理政策。
In the South-west Thames Region over the period 1970-8 the number of admissions for asthma in children aged 5-14 years increased from 256 to 684, an increase of 167%. Factors associated with this trend were investigated by an analysis of routine hospital statistics and examination of case notes for 1970 and 1978 from every hospital in the region. The trend was caused partly by an increase in readmission rates. There was a more than fivefold increase in self-referrals; these patients had less severe asthma on admission and a higher readmission rate than patients referred by general practitioners. Drug management before and after admission changed considerably over the nine years, as did hospital investigations. Overall, there was little change in the level of severity on admission. The increase in admissions was not associated with a reduction in deaths from asthma in the region and occurred in spite of major advances in the drug control of asthma; this indicates an inadequacy of ambulatory care. The shift in the balance of care towards the hospital and the increasing adoption of a primary care function by the hospital indicate a need for hospitals and general practice to agree jointly on management policies for acute asthma.