A New Functional Assessment Tool to Evaluate Medical and Care Need

老年病量表的定义是《老年医学》教科书中列出的老年人老年综合征的体征和症状的总和。我们共调查了474名受试者。其中包括436名急症护理医院、慢性护理医院和长期护理机构的机构性受试者以及36名使用家庭护理的社区居住受试者。老年人量表在家庭护理中的平均值为6，在急症护理医院中为6.5，在慢性护理医院中为9，在长期护理机构中为9。所谓的老年综合征可以分为三组；75岁后症状急剧增加（Older old）， 65岁后症状逐渐增加（Young old），受年龄影响最小（Constant）。在以家庭为基础的护理对象中，老年比例相对较小。然而老年病的三层证型基本没有区别。在长期护理机构中，虽然存在三层模式，但“老年”综合征在75岁之前增加。换句话说，在护理医院，低ADL患者的护理负担可能较重。慢性护理医院的模式与护理医院相似。根据某慢性护理医院患者一年的预后，回到家中的患者的老年规模约为转入长期护理机构的患者的一半。具体来说，应该注意的是，在回家的患者中，老年人的因素非常小。综上所述，老年证候汇总和老年证候分型分析是评估护理需求和医疗需求的新工具。这将有助于制定出院计划。

Geriatric Scale is defined as sum of signs and symptoms which are listed as geriatric syndrome in the elderly in text books of Geriatric Medicine. We investigated 474 subjects in total. These include 436 institutionalized subjects in acute care hospital, chronic care hospital, and long term care facility as well as 36 community dwelling subjects who use home-based care. Mean value of Geriatric Scale was 6 in home-based care, 6.5 in an acute care hospital, 9 in a chronic care hospital and 9 in a long term care facility. So-called geriatric syndromes were able to be categorized into 3 groups ; syndromes steeply increased after 75 years old (Older Old), syndromes increased gradually after 65 years old (Young Old) and syndromes least influenced by age (Constant).In subjects with home-based care, geriatric scale is relatively small. However 3 layer pattern of geriatric syndrome is basically not different. In a long term care facility, Although, 3 layer pattern is found, the syndromes "Older Old" increased before 75 years old. In other words, in nursing hospital, care-burden with low ADL may be heavy. The pattern in a chronic care hospital is similar that of nursing hospital. According to one year prognosis of patients in a chronic care hospital, the geriatric scale of patients who came back to home is about half of that of patients who were transferred to long term care facilities.Specifically, it should be noted that the element of Older Old is very small in patients who came back to home. In conclusion, the sum of geriatric syndromes and analysis of pattern of geriatric syndromes are new tool to evaluate care need and medical need. And it will help to make a discharge planning.