Millner B N
Physically Handicapped Children's Program, New York State Department of Health, Albany 12237.
Bull N Y Acad Med. 1991 Mar-Apr;67(2):131-42.
A survey in New York State revealed 210 medically stable technology-dependent children retained inappropriately in acute-care hospitals. They remained in hospitals primarily because of a shortage of skilled home nursing services in the communities where they lived, family problems that prevented their care at home, and a shortage of beds in appropriate skilled nursing facilities. Most of the children were younger than one year of age, most had disorders of the central nervous system or respiratory system, and most needed respiratory support. The average child needed more than 13 hours of skilled nursing care per day. With adequate nursing services, many of these children could be cared for in their homes. For some, family care was not feasible because of social, psychological, and economic problems. To make it possible to care for medically stable technology-dependent children most effectively, we must develop additional community-based resources. Home nursing services of the highly skilled kind needed to care for them are in short supply today in New York State. There is a shortage of beds in extended care nursing facilities capable of caring for them, especially for infants and very young children. There is a shortage of the other supportive social services needed by families who attempt to care for them at home. Until we address these needs and develop these services, technology-dependent children medically appropriate for care outside acute-care hospitals will be forced to remain hospitalized, to the detriment of the children and their families.
纽约州的一项调查显示，有210名医疗状况稳定但依赖技术的儿童被不恰当地留在了急症医院。他们留在医院主要是因为他们居住的社区缺乏熟练的家庭护理服务、存在阻碍他们在家中接受护理的家庭问题，以及合适的专业护理机构床位短缺。大多数儿童年龄不到一岁，大多数患有中枢神经系统或呼吸系统疾病，并且大多数需要呼吸支持。平均每个儿童每天需要超过13小时的专业护理。如果有足够的护理服务，这些儿童中的许多人可以在家中得到照料。对一些儿童来说，由于社会、心理和经济问题，家庭护理不可行。为了能够最有效地照料医疗状况稳定但依赖技术的儿童，我们必须开发更多基于社区的资源。如今在纽约州，照料这些儿童所需的高技能家庭护理服务短缺。能够照料他们的长期护理机构床位短缺，尤其是针对婴儿和非常年幼的儿童。试图在家中照料他们的家庭所需的其他支持性社会服务也短缺。在我们满足这些需求并开发这些服务之前，医疗上适合在急症医院之外接受护理的依赖技术的儿童将被迫继续住院，这对儿童及其家庭都不利。
