Griffiths Peter, Sironi Cecilia
Florence Nightingale School of Nursing and Midwifery, King's College London, Room 3.29b JCMB, UK.
Int J Nurs Stud. 2005 Jul;42(5):507-12. doi: 10.1016/j.ijnurstu.2004.07.009.
Despite considerable literature identifying large numbers of post-acute patients in acute medical wards, their needs have not been clearly described. Such information is required to plan alternative services.
Identify the size of and care needs of the post-acute population within the group of patients receiving acute medical care in an Italian General Hospital.
Five medical wards of a District General Hospital in Northern Italy.
Point prevalence survey. Data were collected on all 211 patients using the most recent Italian version of the Appropriateness Evaluation protocol, Barthel Index, and the Northwick Park Dependency Score. Length of stay up to the data collection (index) day and total length of stay were identified and pre- and post-discharge dependence was assessed.
The mean of the length of stay of the patients up to the index day was 12 days. Fourty four percent of patients were assessed as inappropriate. The mean age was 70 years. They were moderately physically dependent and stayed in hospital for a further 8 days after the day of the survey. The family met most of the care needs both before and after admission to hospital. Inappropriate patients differed little from the appropriate patients in terms of their care needs, which were relatively high.
There is scope for the development of alternatives to acute care in the Italian health service but the intensity on non-medical care needs is not discernibly lower than for acute care. Prospective identification of patients who might require such services using tools that focus on needs other than medical needs remains problematic.
尽管有大量文献指出急性内科病房中有大量急性后期患者，但其需求尚未得到清晰描述。规划替代服务需要此类信息。
确定意大利一家综合医院接受急性内科治疗的患者群体中急性后期患者的规模及其护理需求。
意大利北部一家地区综合医院的五个内科病房。
现患率调查。使用最新意大利语版的适宜性评估方案、巴氏指数和诺斯威克公园依赖评分，收集了所有211名患者的数据。确定了截至数据收集（索引）日的住院时间和总住院时间，并评估了出院前后的依赖程度。
截至索引日患者的平均住院时间为12天。44%的患者被评估为不适当。平均年龄为70岁。他们身体有中度依赖，在调查日后还需住院8天。家庭在患者入院前后满足了大部分护理需求。不适当患者与适当患者在护理需求方面差异不大，护理需求都相对较高。
意大利医疗服务中急性护理替代方案的发展有空间，但非医疗护理需求的强度并不明显低于急性护理。使用关注医疗需求以外需求的工具对可能需要此类服务的患者进行前瞻性识别仍然存在问题。
