Mills Terry L, Lichtenberg Peter A, Wakeman Melanie A, Scott-Okafor Hellena
J Natl Med Assoc. 2002 Sep;94(9):846-55.
This study addresses a gap in the current literature on the correlates of rehabilitation hospital length of stay for older African Americans. Using data from 616 consecutively admitted rehabilitation patients who ranged in age from 50 to 103 years old, we tested the effect of patient's primary medical impairment; structural factors such as admit and discharge setting; level of depression (Geriatric Depression Scale); functional ability upon hospital admission (FIM score); and other control variables. Hierarchical linear regression models show that medical impairment alone was not a robust predictor of LOS. However, when controlling for structural and psychosocial factors, and medical condition, then circulation/amputation impairment was directly associated with longer LOS. Being unmarried or at risk for depression were also directly related to longer LOS. Consequently, rehabilitation administrators and hospital staff should note these findings to determine whether and how these factors affect discharge outcomes in their particular rehabilitative environments.
本研究填补了当前文献中关于老年非裔美国人康复医院住院时间相关因素的空白。我们使用了616名年龄在50至103岁之间的连续入院康复患者的数据,测试了患者的主要医疗损伤;诸如入院和出院环境等结构因素;抑郁水平(老年抑郁量表);入院时的功能能力(FIM评分)以及其他控制变量的影响。分层线性回归模型显示,仅医疗损伤并不是住院时间的有力预测因素。然而,在控制了结构和社会心理因素以及医疗状况后,循环系统/截肢损伤与更长的住院时间直接相关。未婚或有抑郁风险也与更长的住院时间直接相关。因此,康复管理人员和医院工作人员应注意这些发现,以确定这些因素是否以及如何在他们特定的康复环境中影响出院结果。