Wilkinson T J, Sainsbury R
Department of Health Care of the Elderly, Princess Margaret Hospital, Christchurch.
N Z Med J. 1992 Nov 11;105(945):451-2.
To determine whether requests for placement of an elderly person into rest home or hospital care accurately predicted the final outcome and to identify factors influencing a move to institutional care.
Three month audit of all referrals to an assessment and rehabilitation unit for the elderly requesting rest home or hospital placement. Requests for medical advice or rehabilitation were excluded.
Two hundred patients were studied (24.6% of all referrals). Placement was requested in a rest home in 132 and hospital in 68. Seventy-one (54%) patients referred for rest home placement were able to return to their own home and 64 remained there at six month follow-up. Hospital level care was assessed as appropriate in 62% of requests for this initially and at six month follow up. Age and diagnosis were not significant predictors of patients requiring placement. Overall, of 158 patients living at home referred for rest home or hospital care, 67 (42%) were managing at home six months later.
Accurate assessment and treatment/management of elderly patients is necessary before recommending higher levels of care. Patients can be maintained in their current environment for longer than perceived by the referring doctor. This has important social and financial benefits.
确定将老年人安置到养老院或医院护理的请求是否能准确预测最终结果，并确定影响转至机构护理的因素。
对所有转介至老年评估与康复单位、请求安置到养老院或医院的案例进行为期三个月的审核。排除寻求医疗建议或康复的请求。
共研究了200名患者（占所有转介案例的24.6%）。其中132人请求安置到养老院，68人请求安置到医院。转介至养老院安置的患者中，71人（54%）能够返回家中，6个月随访时仍有64人在家中。最初及6个月随访时，62%的医院护理请求被评估为合适。年龄和诊断并非需要安置患者的显著预测因素。总体而言，158名在家居住、被转介至养老院或医院护理的患者中，67人（42%）6个月后仍在家中自理。
在建议提供更高水平护理之前，对老年患者进行准确评估和治疗/管理是必要的。患者能够在当前环境中维持的时间比转诊医生认为的更长。这具有重要的社会和经济效益。
