Marcantonio Edward R, O'Malley A James, Murkofsky Rachel L, Caudry Daryl J, Buchanan Joan L
Harvard Medical School & Beth Israel Deaconess Medical Center, USA.
J Aging Health. 2006 Dec;18(6):869-84. doi: 10.1177/0898264306293617.
To derive and confirm scales measuring medical director's attitudes about hospitalization of nursing home residents.
The authors surveyed nursing facility medical directors about the necessity of hospitalizing residents for eight clinical conditions and compared the ratings to those obtained from an expert panel to derive a relative hospitalization score. They also asked about factors that might influence hospitalization decisions. They performed a factor analysis to derive scales that measure attitudinal determinants of hospitalization and used the relative hospitalization score to confirm the scales.
The survey had a 79% response rate. The relative hospitalization score demonstrated that medical directors were slightly less likely to recommend hospitalization than expert panel physicians. Factor analyses yielded 10 scales focusing on nursing home functioning, economics, resident specific considerations, and physician attitudes. Eight of the 10 scales had significant bivariable associations with the relative hospitalization score, and 6 had significant multivariable associations.
Medical directors identify multiple determinants of hospitalization for nursing facility residents across several domains. Hospitalization decisions for nursing facility residents are complex and involve clinical and nonclinical factors.
推导并验证用于衡量医疗主任对疗养院居民住院态度的量表。
作者就八种临床情况询问了护理机构医疗主任让居民住院的必要性，并将评分与专家小组的评分进行比较，以得出相对住院评分。他们还询问了可能影响住院决策的因素。他们进行了因子分析以推导出衡量住院态度决定因素的量表，并使用相对住院评分来验证这些量表。
调查的回复率为79%。相对住院评分表明，医疗主任推荐住院的可能性略低于专家小组医生。因子分析得出了10个量表，重点关注疗养院功能、经济、居民特定因素和医生态度。10个量表中有8个与相对住院评分有显著的双变量关联，6个有显著的多变量关联。
医疗主任确定了疗养院居民住院的多个决定因素，涉及多个领域。疗养院居民的住院决策很复杂，涉及临床和非临床因素。
