Factors associated with the high prevalence of short hospice stays.
Factors associated with the high prevalence of short hospice stays.
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DOI：
10.1089/109662103322515239
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发表时间：
2003-10-01
影响因子：
2.8
通讯作者：
Kinzbrunner, Barrt
中科院分区：
文献类型：
--
作者：
Miller, Susan C;Weitzen, Sherry;Kinzbrunner, Barrt
本研究的目的是了解与7天或更短的安宁疗护时间（即短安宁疗护时间）相关的因素，并检验与社会人口统计学、诊断和疗护地点的变化无关的假设，即短安宁疗护时间的可能性随著时间的推移而增加。我们调查了1994年10月至1999年9月间，在美国7个州的21家安宁疗护所住院的46655名疗养院病人和80507名非疗养院病人的住院情况，这些安宁疗护所由一家提供者所有。使用逻辑回归来确定与短期停留的高概率显著相关的因素。与1995年（财政年度）入院的患者相比，在控制潜在混杂因素的情况下，1995年之后在养老院短期住院的概率每年都显著增加，1999年在非养老院环境中。在1995（财政年度），入住临终关怀的养老院居民有26%的概率（95%可信区间[CI] 0.24, 0.28）住院时间少于8天，在1999（财政年度），这一概率为33%(95%可信区间[CI] 0.31, 0.34)；非养老院患者1995年的概率为32% (95% CI 0.30, 0.34)， 1999年的概率为36% （95% CI 0.34, 0.37）。非癌症诊断患者短期安宁疗护的机率更大，与安宁疗护入院年份无关。在本文中，我们讨论了短期安宁疗护的可能性增加的潜在原因，并推测这种增加在安宁疗护提供高质量临终关怀的能力方面可能意味着什么。
This study's goal was to gain an understanding of the factors associated with hospice stays of 7 days or less (i.e., short hospice stays), and to test the hypothesis that independent of changes in sociodemographics, diagnoses, and site-of-care, the likelihood of a short hospice stay increased over time. We examined hospice stays for 46655 nursing home and 80507 non-nursing home patients admitted between October 1994 and September 1999 to 21 hospices across 7 states, and owned by 1 provider. Logistic regression was used to determine the factors significantly associated with a higher probability of a short stay. Compared to patients admitted in (fiscal year) 1995, and controlling for potential confounders, the probability of a short stay significantly increased in each year after 1995 in nursing homes, and in 1999 in non-nursing home settings. In (fiscal year) 1995, a nursing home resident admitted to hospice had a 26% probability (95% confidence interval [CI] 0.24, 0.28) of a less than 8-day stay and, in (fiscal year) 1999, the probability was 33% (95% CI 0.31, 0.34); a non-nursing home patient had a 32% probability in 1995 (95% CI 0.30, 0.34) and a 36% probability in 1999 (95% CI 0.34, 0.37). The probability of a short hospice stay was greater for patients with noncancer diagnoses, independent of year of hospice admission. In this paper we discuss the possible underlying reasons for the increased probability of short hospice stays and we speculate on what this increase may mean in terms of hospice's ability to provide high-quality end-of-life care.