香港老年内科患者的医院再入院情况。
Hospital readmission among older medical patients in Hong Kong.
作者信息
Kwok T, Lau E, Woo J, Luk J K, Wong E, Sham A, Lee S H
机构信息
Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, New Territories Hong Kong.
出版信息
J R Coll Physicians Lond. 1999 Mar-Apr;33(2):153-6.
OBJECTIVE
To study the risk factors for hospital readmission among older medical patients in Hong Kong.
DESIGN
Cohort study.
SUBJECTS
1,204 consecutive hospital medical patients aged 70 years and over in Hong Kong.
PROCEDURES
Subjects were interviewed by a research nurse on discharge, and were followed up for six months.
OUTCOME
Unplanned hospital readmissions were identified and classified as avoidable or unavoidable. The risk factors for early (within 28 days), recurrent (three or more) and avoidable readmissions were studied by multiple logistic regression.
RESULTS
Four hundred and fifty-five patients (37.7%) had at least one readmission in six months; 18%, 6.4%, and 2.9% of subjects had early, recurrent and avoidable readmissions respectively. Recent hospital stay predicted all types of readmissions. Early readmission was predicted by length of stay, Barthel index (assessment of physical and mental function) and unresolved medical problems. Recurrence readmission was predicted by poor family support, residence in a home for the elderly and unresolved medical problems.
CONCLUSIONS
Hospital readmission may be prevented by ensuring adequate length of stay, so that medical problems are resolved before discharge.
目的
研究香港老年内科患者再次入院的风险因素。
设计
队列研究。
研究对象
香港1204例连续入院的70岁及以上内科患者。
研究方法
研究护士在患者出院时对其进行访谈，并随访6个月。
研究结果
确定非计划再次入院情况，并将其分为可避免和不可避免两类。通过多因素logistic回归分析早期（28天内）、反复（3次及以上）和可避免再次入院的风险因素。
结果
455例患者（37.7%）在6个月内至少有1次再次入院；18%、6.4%和2.9%的患者分别发生早期、反复和可避免再次入院。近期住院史可预测所有类型的再次入院。住院时间、巴氏指数（身心功能评估）和未解决的医疗问题可预测早期再次入院。家庭支持差、居住在养老院和未解决的医疗问题可预测反复再次入院。
结论
确保足够的住院时间，以便在出院前解决医疗问题，可预防再次入院。
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