Weingarden S I, Graham P
Southfield Rehab Hospital, Michigan 48075.
Paraplegia. 1992 Dec;30(12):828-33. doi: 10.1038/sc.1992.159.
Most spinal cord injured (SCI) patients are discharged to their homes and families after they complete their initial rehabilitation program. Nursing homes, however, were the discharge destinations for 3.9% of all SCI patients nationally. When a nursing home is the only discharge option for a young SCI adult, certain economic, medical and psychosocial incongruencies make this placement potentially stressful for both the nursing home staff and the young patient. This study of the rehospitalization of 12 SCI patients under the age of 50 who were discharged to nursing homes explores the issues of cost, care and outcome during their first year following nursing home admission. Nine of the 12 patients were rehospitalized a total of 21 times, mainly for urinary tract infections and decubiti. Charges for 18 of these 21 rehospitalizations amounted to over $423,110 for 599 days of care. Four of these 9 patients died before the end of the first year. Although this is a retrospective study of the medical records and follow up data for a small key group of SCI patients, it calls attention to the need for continued investigation into the outcomes of a minimally visible population that lacks advocacy for change.
大多数脊髓损伤（SCI）患者在完成初始康复计划后会出院回家与家人团聚。然而，在全国范围内，疗养院是3.9%的SCI患者的出院目的地。当疗养院是年轻SCI成年人唯一的出院选择时，某些经济、医疗和心理社会方面的不协调因素使得这种安置对疗养院工作人员和年轻患者来说都可能造成压力。这项针对12名50岁以下出院至疗养院的SCI患者再住院情况的研究，探讨了他们入住疗养院后第一年的费用、护理和结局问题。12名患者中有9名总共再住院21次，主要原因是尿路感染和褥疮。这21次再住院中的18次费用总计超过423,110美元，护理时长为599天。这9名患者中有4名在第一年末之前死亡。尽管这是对一小部分关键SCI患者的病历和随访数据进行的回顾性研究，但它提醒人们需要继续调查这一缺乏变革倡导者的极少受到关注的人群的结局情况。
