Jones K R
School of Nursing, University of Michigan, Ann Arbor 48109.
Health Serv Res. 1991 Dec;26(5):671-99.
This study examines the hospitalization experience of a sample of chronic hemodialysis patients, using primary data sources. There were multiple causes of hospitalization over the six-month tracking period, with stays extending from 1 to 87 days. Patients were more likely to be hospitalized if they had a negative hepatitis antigen, lower functional status scores, lower phosphate and protein levels, repeated access procedures, other cardiovascular conditions, arthritis, psychiatric disorders, ischemic peripheral vascular disease, lung disease, or larger households. Hospitalization for access-related problems was associated with arthritis, previous access procedures, and blood pressure levels. Sociodemographic and treatment characteristics did not have a significant influence on the risk of hospitalization. Improved management in these clinical areas may improve the quality of life of chronic hemodialysis patients and reduce the high level of expenditures associated with delivering inpatient services to this segment of the Medicare population.
本研究利用原始数据源,考察了一组慢性血液透析患者的住院经历。在为期六个月的跟踪期内,住院原因多种多样,住院时间从1天到87天不等。如果患者乙肝抗原呈阴性、功能状态评分较低、磷酸盐和蛋白质水平较低、反复进行血管通路手术、患有其他心血管疾病、关节炎、精神障碍、缺血性外周血管疾病、肺部疾病或家庭规模较大,则更有可能住院。因血管通路相关问题住院与关节炎、既往血管通路手术及血压水平有关。社会人口统计学和治疗特征对住院风险没有显著影响。改善这些临床领域的管理,可能会提高慢性血液透析患者的生活质量,并降低为医疗保险人群中的这部分患者提供住院服务所产生的高额费用。