Weiler P G, Cooper J K
University of California, Davis.
J Aging Health. 1990 Aug;2(3):395-410. doi: 10.1177/089826439000200307.
The number of elderly residing in, and dying in, nursing homes is steadily increasing. In 1985, an investigation by the California attorney general's office was undertaken concerning a cluster of deaths in a single rural nursing home. The purpose of this study was to provide information for the investigation. The objectives of the study were to determine if there were excess deaths in the nursing home, and if so, to describe the circumstances surrounding the deaths and the policy implications for the quality of care in nursing homes. All the medical records for patients who died in a single nursing home between January 1, 1983 and April 30, 1985 were examined by the research team. Medical care was compared to desirable standards of care. A majority of the deaths, 52.5%, had major discrepancies from standard care that may have contributed to the patient's death. There were also major discrepancies in the cause of death between the death certificate and evidence from examination of the medical records. The data substantiated an unusual occurrence of deaths in the nursing home at the end of 1983 and again in early 1985, but no single factor or person could be identified as the major cause of the deaths. Although this is an isolated study of one nursing home, it is likely that these problems are not unique and the evaluation approach may be useful in other settings. It is recommended that nursing home deaths be routinely monitored, and that an unusual number of deaths should trigger an extensive investigation.
居住在养老院并在养老院去世的老年人数量正在稳步增加。1985年，加利福尼亚州总检察长办公室针对一家农村养老院发生的一系列死亡事件展开了调查。本研究的目的是为该调查提供信息。该研究的目标是确定该养老院是否存在过多死亡情况，如果存在，描述死亡事件的相关情况以及对养老院护理质量的政策影响。研究团队查阅了1983年1月1日至1985年4月30日期间在一家养老院死亡的所有患者的病历。将医疗护理情况与理想的护理标准进行了比较。大多数死亡病例（52.5%）与标准护理存在重大差异，这些差异可能导致了患者死亡。死亡证明上的死因与病历检查证据之间也存在重大差异。数据证实了1983年底和1985年初该养老院出现了异常死亡情况，但无法确定单一因素或个人为主要死因。尽管这是对一家养老院的单独研究，但这些问题可能并非该养老院独有，且这种评估方法可能在其他环境中也有用。建议对养老院死亡情况进行常规监测，异常数量的死亡事件应引发全面调查。
