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脊髓损伤后健康服务的利用情况:一项为期6年的随访研究。

Utilization of health services following spinal cord injury: a 6-year follow-up study.

作者信息

Dryden D M, Saunders L D, Rowe B H, May L A, Yiannakoulias N, Svenson L W, Schopflocher D P, Voaklander D C

机构信息

Department of Public Health Sciences, University of Alberta, Edmonton, AB, Canada.

出版信息

Spinal Cord. 2004 Sep;42(9):513-25. doi: 10.1038/sj.sc.3101629.

Abstract

STUDY DESIGN

Cohort study with 6-years follow-up.

OBJECTIVE

To describe the utilization of health services by persons with spinal cord injury (SCI) and compare it with that of the general population.

SETTING

Alberta, Canada.

METHODS

All persons who sustained an SCI in Alberta between April 1992 and March 1994 were followed from date of injury to 6 years postinjury. Cases were matched (1:5) with controls randomly selected from the general population and matched for age, gender, and region of residence. Administrative data from centralized health care databases were compiled to provide a complete picture of health care use, including hospitalizations, physician contacts, long-term care admissions, home care services, and the occurrence of secondary complications.

RESULTS

In all, 233 individuals with SCI and 1165 matched controls were followed for 6 years. Compared with the control group, persons with SCI were rehospitalized 2.6 times more often, spent 3.3 more days in hospital, were 2.7 times more likely to have a physician contact, and required 30 times more hours of home care services. Of those with SCI, 47.6% were treated for a urinary tract infection, 33.8% for pneumonia, 27.5% for depression, and 19.7% for decubitus ulcer.

CONCLUSION

SCI places a heavy burden on the health care system. Persons with SCI have greater rates of contact with the health system compared with the general population. Secondary complications continue to affect persons with SCI long after the acute trauma.

摘要

研究设计

为期6年随访的队列研究。

目的

描述脊髓损伤(SCI)患者的卫生服务利用情况,并与普通人群进行比较。

地点

加拿大艾伯塔省。

方法

对1992年4月至1994年3月期间在艾伯塔省发生脊髓损伤的所有患者从受伤之日起随访至受伤后6年。病例与从普通人群中随机选取的对照组按1:5进行匹配,并在年龄、性别和居住地区方面进行匹配。汇总来自集中式医疗保健数据库的管理数据,以全面了解医疗保健使用情况,包括住院、与医生接触、长期护理入院、家庭护理服务以及继发性并发症的发生情况。

结果

总共对233例脊髓损伤患者和1165例匹配的对照组进行了6年的随访。与对照组相比,脊髓损伤患者的再次住院频率高2.6倍,住院天数多3.3天,与医生接触的可能性高2.7倍,所需家庭护理服务时间多30倍。在脊髓损伤患者中,47.6%接受了尿路感染治疗,33.8%接受了肺炎治疗,27.5%接受了抑郁症治疗,19.7%接受了褥疮治疗。

结论

脊髓损伤给医疗保健系统带来沉重负担。与普通人群相比,脊髓损伤患者与卫生系统的接触率更高。急性创伤后很长时间,继发性并发症仍持续影响脊髓损伤患者。

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