Division of Geriatrics, Rhode Island Hospital, Brown Medical School, 593 Eddy Street, Providence, RI 02903, USA.
J Am Med Dir Assoc. 2010 Jan;11(1):21-5. doi: 10.1016/j.jamda.2009.07.011. Epub 2009 Nov 25.
To examine the association of family members' perception about the adequacy of home health services at the last place of care before death.
Retrospective cross-sectional study. Mortality follow-back survey by telephone interview.
Home health services.
Bereaved family members or knowledgeable informants of deceased persons in 22 states.
Proxy perception of need of home health care during the last 12 months of decedent's life, whether the amount of care received was enough, and last place of care (ie, where the person spent at least 48 hours nearest to the time of death).
Of the 1578 interviews, 622 informants reported that decedents needed home health care in the last year of life. Among decedents needing home health care, 144 informants reported that the home health services provided did not meet their needs. After adjusting for age, gender, insurance, education, race, cause of death, functional status, and place of residence, decedents reported as not receiving enough home health care were 1.8 (95% CI 1.1-2.9) times more likely to die in a nursing home.
The perception that home health services before death did not meet the decedent's needs may contribute to greater nursing home use.
调查临终前最后一个家庭护理地点的家庭成员对家庭健康服务充足性的感知与该护理地点的关联性。
回顾性的横断面研究。通过电话访谈进行死亡后追踪调查。
家庭健康服务机构。
22 个州的死亡者的家属或知情人士。
代理感知患者在去世前 12 个月内对家庭健康护理的需求程度、接受的护理量是否足够，以及最后一个护理地点（即患者在临近死亡时间至少接受 48 小时护理的地点）。
在 1578 次访谈中，有 622 名知情人士报告称患者在生命的最后一年需要家庭健康护理。在需要家庭健康护理的患者中，有 144 名知情人士报告称提供的家庭健康服务未能满足他们的需求。在调整年龄、性别、保险、教育程度、种族、死因、功能状态和居住地点后，报告称接受的家庭健康护理不足的患者死亡时更有可能在疗养院（nursing home）。
临终前认为家庭健康服务未能满足患者需求的感知可能导致更多的患者入住疗养院。
