Health status of UK care home residents: a cohort study
Health status of UK care home residents: a cohort study
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DOI：
10.1093/ageing/aft077
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发表时间：
2014-01-01
期刊：
影响因子：
6.7
通讯作者：
Gladman, John R. F.
中科院分区：
文献类型：
--
作者：
Gordon, Adam Lee;Franklin, Matthew;Gladman, John R. F.
背景：英国护理院的居民往往服务差，现有的医疗保健安排。由于缺乏细节和使用的数据来自社会调查，而不是卫生保健记录，已公布的居民健康状况描述受到限制。目的：详细描述英国护理院居民的健康状况和医疗保健资源的使用。设计和环境：一项为期180天的纵向队列研究，研究对象是来自11家英国护理院的227名居民，其中5家是护理，6家是住宿，这些被选中作为护理/住宿状况和痴呆症登记的代表。方法：基线时记录Barthel指数（BI）、简易精神状态检查（MMSE）、神经精神指数（NPI）、简易营养指数（MNA）、EuroQoL-5D （EQ-5D）、12项一般健康问卷（GHQ-12）、诊断和用药情况，180 d后随访BI、NPI、GHQ-12和EQ-5D。国家卫生服务（NHS）的资源使用数据是从当地卫生保健提供者的数据库中收集的。结果：在323名居民中，招募了227名居民。中位BI为9 (IQR: 2.5-15.5)， MMSE为13(4-22)，用药数为8（5.5-10.5）。每位居民平均诊断次数为6.2 （SD: 4）。30%的人营养不良，66%的人有行为障碍。居民平均每月与NHS联系一次。结论：来自住宿和护理机构的居民都具有依赖性，认知障碍，轻度频繁的行为症状，多病，多药，经常使用NHS资源。对这样一个群体的有效护理需要以协调和管理的方式提供来自多个学科的广泛专业知识。
Background: UK care home residents are often poorly served by existing healthcare arrangements. Published descriptions of residents' health status have been limited by lack of detail and use of data derived from surveys drawn from social, rather than health, care records.Aim: to describe in detail the health status and healthcare resource use of UK care home residentsDesign and setting: a 180-day longitudinal cohort study of 227 residents across 11 UK care homes, 5 nursing and 6 residential, selected to be representative for nursing/residential status and dementia registration.Method: Barthel index (BI), Mini-mental state examination (MMSE), Neuropsychiatric index (NPI), Mini-nutritional index (MNA), EuroQoL-5D (EQ-5D), 12-item General Health Questionnaire (GHQ-12), diagnoses and medications were recorded at baseline and BI, NPI, GHQ-12 and EQ-5D at follow-up after 180 days. National Health Service (NHS) resource use data were collected from databases of local healthcare providers.Results: out of a total of 323, 227 residents were recruited. The median BI was 9 (IQR: 2.5-15.5), MMSE 13 (4-22) and number of medications 8 (5.5-10.5). The mean number of diagnoses per resident was 6.2 (SD: 4). Thirty per cent were malnourished, 66% had evidence of behavioural disturbance. Residents had contact with the NHS on average once per month.Conclusion: residents from both residential and nursing settings are dependent, cognitively impaired, have mild frequent behavioural symptoms, multimorbidity, polypharmacy and frequently use NHS resources. Effective care for such a cohort requires broad expertise from multiple disciplines delivered in a co-ordinated and managed way.