Transitional care facility for elderly people in hospital awaiting a long term care bed: randomised controlled trial
Transitional care facility for elderly people in hospital awaiting a long term care bed: randomised controlled trial
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DOI：
10.1136/bmj.38638.441933.63
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发表时间：
2005-11-12
影响因子：
105.7
通讯作者：
Phillips, PA
中科院分区：
文献类型：
--
作者：
Crotty, M;Whitehead, CH;Phillips, PA
目的评估将在医院等待长期护理床位的患者转移到异地过渡性护理机构的有效性。设计随机对照试验。设置阿德莱德南部的三家公立医院。参与者320名老年患者（平均年龄83岁）（212例随机接受干预，108控制）干预措施过渡性护理设施，所有患者都接受了专家老年护理团队的单一评估和适当的持续治疗。主要结果测量住院时间、再入院率、死亡率、患者功能水平（改良Barthel指数）、生活质量（生活质量评估）和4个月时的护理需求（居住分类量表）。结果从入院起，干预组患者住院时间的中位数为32.5天（95%置信区间为29至36天）。在对照组中，中位住院时间为43.5天（41 - 51天）（差异为6 - 16天的95%置信区间）。干预组患者接受永久护理的时间比对照组多21天（6至27天）。在两组中，很少有患者回家（干预组14例（7%），对照组9例（9%））。有没有显着差异的死亡率（28%对27%）或率转回医院（28%对25%）。结论对于体弱的老年患者谁正在等待一个住宅护理床转出医院到场外过渡性护理单位，重点是老年护理“畅通的床”没有不良影响。
Objective To assess the effectiveness of moving patients who are waiting in hospital for a lone term care bed to an off-site transitional care facility.Design Randomised controlled trial.Setting Three public hospitals in Southern Adelaide.Participants 320 elderly patients (mean age 83 years) in acute hospital beds (212 randomised to intervention, 108 to control).Interventions A transitional care facility where all patients received a single assessment from a specialist elder care team and appropriate ongoing therapy.Main outcome measures Length of stay in hospital, rates of readmission, deaths, and patient's functional level (modified Barthel index), quality of life (assessment of quality of life), and care needs (residential classification scale) at four months.Results From admission, those in the intervention group stayed a median of 32.5 days (95% confidence interval 29 to 36 days) in hospital. In the control group the median length of stay was 43.5 days (41 to 51 days) (95% confidence interval for difference 6 to 16 days). Patients in the intervention g roup took a median of 21 days (6 to 27 days) longer to be admitted to permanent care than those in the control group. In both groups few patients went home (14 (7%) in the intervention group v 9 (9%) in the control group). There were no significant differences in death rates (28% v 27%) or rates of transfer back to hospital (28% v 25%).Conclusions For frail elderly patients who are awaiting a residential care bed transfer out of hospital to an off-site transitional care unit with focus on aged care "unblocks beds" without adverse effects.