Landi F, Onder G, Russo A, Tabaccanti S, Rollo R, Federici S, Tua E, Cesari M, Bernabei R
Department of Gerontology and Geriatrics, Catholic University of Sacred Heart, Rome, Italy.
J Clin Epidemiol. 2001 Sep;54(9):968-70. doi: 10.1016/s0895-4356(01)00366-3.
The objective of the present study was to examine the effect of a home care program based on comprehensive geriatric assessment-Minimum Data Set for Home Care-and case management on hospital use/cost of frail elderly individuals. We determined all hospital admissions and days spent in hospital during the first year since the implementation of the home care program, and compared them to the rate of hospitalization that the same patients had experienced in the year preceding the implementation of such program. Following the implementation of this program, there was a significant reduction of the number of hospitalizations (pre 44% vs. post 26%, P < 0.001), associated with a reduction of hospital days, both at the individual patient level and for each admission. In conclusion, an integrated home care program based on the implementation of a comprehensive geriatric assessment instrument guided by a case manager has a significant impact on hospitalization and is cost-effective.
本研究的目的是探讨基于综合老年评估——家庭护理最低数据集——以及病例管理的家庭护理计划对体弱老年人住院使用情况/费用的影响。我们确定了家庭护理计划实施后第一年的所有住院情况及住院天数，并将其与同一患者在该计划实施前一年的住院率进行比较。实施该计划后，住院次数显著减少（实施前为44%，实施后为26%，P<0.001），同时个体患者层面以及每次住院的住院天数均有所减少。总之，基于病例管理者指导下实施综合老年评估工具的综合家庭护理计划对住院情况有显著影响且具有成本效益。
