Emergency department visits by nursing home residents in the United States.
Emergency department visits by nursing home residents in the United States.
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DOI：
10.1111/j.1532-5415.2011.03587.x
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发表时间：
2011-10
影响因子：
6.3
通讯作者：
Kilgore M
中科院分区：
文献类型：
--
作者：
Wang HE;Shah MN;Allman RM;Kilgore M
急诊科（艾德）是疗养院居民的重要医疗保健来源。本研究的目的是描述美国（US）疗养院居民使用艾德的特征。2005-2008年美国急诊科全国医院门诊医疗调查分析：按疗养院和非疗养院居民分层的美国急诊科就诊者。无我们确定了疗养院居民的所有艾德访视。我们比较了养老院居民和非养老院居民的人口统计学和临床特征。我们还比较了艾德资源利用、住院时间和结局。在2005-2008年期间，疗养院居民占475，077，828次美国艾德就诊的9，104，735人（1.9%; 95% CI：1.8-2.1%）。疗养院居民每年的艾德就诊次数为2，276，184次。大多数疗养院居民为老年人（平均76.7岁，95% CI：75.8-77.5）、女性（63.3%）和非西班牙裔白色人（74.8%）。与非疗养院居民相比，疗养院居民更可能在前7天内出院（调整后OR 1.4，95%CI：1.1-1.9）。疗养院居民更可能出现发热（校正OR 1.9; 95% CI：1.5-2.4）或低血压（收缩压≤90 mm Hg，OR 1.8; 95% CI：1.5-2.2）。护理之家的病人更有可能接受诊断测试，成像和程序在ED。几乎一半的护理之家的居民访问的艾德入院。与非疗养院居民相比，疗养院居民更容易入院（调整OR 1.8; 95% CI 1.6-2.1）和死亡（调整OR 2.3; 95% CI 1.6-3.3）。在美国，疗养院的居民每年有超过220万的艾德就诊。与其他艾德患者相比，疗养院居民具有更高的医疗敏锐度和复杂性。这些观察结果突出了在美国组织和提供艾德护理给疗养院居民的国家挑战。
The Emergency Department (ED) is an important source of health care for nursing home residents. The objective of this study was to characterize ED use by nursing home residents in the United States (US). Analysis of the National Hospital Ambulatory Medical Care Survey US Emergency Departments, 2005-2008 Individuals visiting US EDs, stratified by nursing home and non-nursing home residents. None We identified all ED visits by nursing home residents. We contrasted the demographic and clinical characteristics between nursing home residents and non-nursing home residents. We also compared ED resource utilization, length of stay and outcomes. During 2005-2008, nursing home residents accounted for 9,104,735 of 475,077,828 US ED visits (1.9%; 95% CI: 1.8-2.1%). The annualized number of ED visits by nursing home residents was 2,276,184. Most nursing home residents were elderly (mean 76.7 years, 95% CI: 75.8-77.5), female (63.3%), and non-Hispanic White (74.8%). Compared with non-nursing home residents, nursing home residents were more likely have been discharged from the hospital in the prior seven days (adjusted OR 1.4, 95% CI: 1.1-1.9). Nursing home residents were more likely to present with fever (adjusted OR 1.9; 95% CI: 1.5-2.4) or hypotension (systolic blood pressure ≤90 mm Hg, OR 1.8; 95% CI: 1.5-2.2). Nursing home patients were more likely to receive diagnostic test, imaging and procedures in the ED. Almost half of nursing home residents visiting the ED were admitted to the hospital. Compared with non-nursing home residents, nursing home residents were more likely to be admitted to the hospital (adjusted OR 1.8; 95% CI 1.6-2.1) and to die (adjusted OR 2.3; 95% CI 1.6-3.3). Nursing home residents account for over 2.2 million ED visits annually in the US. Compared with other ED patients, nursing home residents have higher medical acuity and complexity. These observations highlight the national challenges of organizing and delivering ED care to nursing home residents in the US.
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DOI：
10.1111/j.1532-5415.2008.01748.x
发表时间：
2008-07-01
影响因子：
6.3
作者：
Boockvar, Kenneth S.;Gruber-Baldini, Ann L.;Magaziner, Jay
通讯作者：
Magaziner, Jay
影响因子：
11.4
作者：
Finn, Judith C.;Flicker, Leon;Sprivulis, Peter
通讯作者：
Sprivulis, Peter
DOI：
10.1111/j.1532-5415.1997.tb01485.x
发表时间：
1997-06-01
影响因子：
6.3
作者：
Gold, S;Bergman, H
通讯作者：
Bergman, H
DOI：
10.5034/inquiryjrnl_40.4.401
发表时间：
2003-12-01
影响因子：
1.7
作者：
Hing, E;Gousen, S;Burt, C
通讯作者：
Burt, C
影响因子：
6.2
作者：
Han, Jin H.;Shintani, Ayumi;Eden, Svetlana;Morandi, Alessandro;Solberg, Laurence M.;Schnelle, John;Dittus, Robert S.;Storrow, Alan B.;Ely, E. Wesley
通讯作者：
Ely, E. Wesley