Condelius Anna, Edberg Anna-Karin, Jakobsson Ulf, Hallberg Ingalill R
Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, 221 00 Lund, Sweden.
Arch Gerontol Geriatr. 2008 Jan-Feb;46(1):41-55. doi: 10.1016/j.archger.2007.02.005. Epub 2007 Apr 2.
This study aimed at examine the number of planned and acute hospital admissions during 1 year among people 65+ and its relation to municipal care, outpatient care, multimorbidity, age and sex. Four thousand nine hundred and seven individuals having one or more admissions during 2001 were studied. Data were collected from two registers and comparisons were made between those having one, two and three or more hospital stays and between those with and without municipal care and services. Linear regression was used to examine factors predicting number of acute and planned admissions. Fifteen percent of the sample had three or more hospital stays (range 3-15) accounting for 35% of all admissions. This group had significantly more contacts in outpatient care with physician (median number of contacts (md)=15), compared to those with one (md: 8), or two admissions (md: 11). Main predictors for number of admissions were number of diagnosis groups and number of contacts with physician in outpatient care. Those who are frequently admitted to hospital constitute a small group that consume a great deal of inpatient care and also tend to have frequent contacts in outpatient care. Thus interventions focusing on frequent admissions are needed, and this requires collaboration between outpatient and hospital care.
本研究旨在调查65岁及以上人群一年内计划住院和急症住院的次数,及其与市政护理、门诊护理、多种疾病、年龄和性别的关系。对2001年期间有一次或多次住院的4907名个体进行了研究。数据从两个登记册收集,并对有一次、两次和三次或更多次住院的人群以及有和没有市政护理及服务的人群进行了比较。采用线性回归分析预测急症和计划住院次数的因素。15%的样本有三次或更多次住院(范围为3 - 15次),占所有住院次数的35%。与有一次住院(中位数:8次)或两次住院(中位数:11次)的人群相比,该组在门诊与医生的接触明显更多(接触次数中位数 = 15次)。住院次数的主要预测因素是诊断组数量和门诊与医生的接触次数。经常住院的人群占比小,但消耗了大量的住院护理资源,并且在门诊也往往有频繁的接触。因此,需要针对频繁住院采取干预措施,这需要门诊护理和医院护理之间的协作。