Codde Jim, Arendts Glenn, Frankel Jackie, Ivey Mary, Reibel Tracy, Bowen Shirley, Babich Paul
South Metropolitan Area Health Service, Perth, Western Australia, Australia.
Australas J Ageing. 2010 Dec;29(4):150-4. doi: 10.1111/j.1741-6612.2010.00418.x.
To assess the impact of an enhanced primary care service for residential aged care facilities (RACF) on the transfer of patients from RACF to a hospital emergency department (ED).
A before-after study of an enhanced primary care service provided by experienced ED-based nurses under the governance of general practitioners. The intervention was analysed comparatively using standardised normal deviates and seasonal autoregressive integrated moving average models, complemented by qualitative assessment.
There was a statistically significant reduction (17%, P < 0.001) in the number of transfers during the intervention period. This finding held when adjusting for the seasonality of ED referrals over a 4-year period. The intervention was highly valued by clinicians in RACF and ED.
Enhanced primary care services reduce the number of transfers to ED from RACF.
评估强化基层医疗服务对老年护理机构(RACF)患者从RACF转至医院急诊科(ED)的影响。
一项关于由经验丰富的急诊科护士在全科医生管理下提供的强化基层医疗服务的前后对照研究。采用标准化正态偏差和季节性自回归积分滑动平均模型对干预进行比较分析,并辅以定性评估。
干预期间转院人数有统计学意义的减少(17%,P<0.001)。在对四年期间急诊科转诊的季节性进行调整后,这一发现依然成立。该干预受到RACF和急诊科临床医生的高度重视。
强化基层医疗服务可减少RACF患者转至急诊科的人数。