Inzitari Marco, Espinosa Serralta Lluís, Pérez Bocanegra María Carmen, Roquè Fíguls Marta, Argimón Pallàs Josep Maria, Farré Calpe Joan
Parc Sanitari Pere Virgili, Barcelona, España.
Gac Sanit. 2012 Mar-Apr;26(2):166-9. doi: 10.1016/j.gaceta.2011.07.007. Epub 2011 Oct 11.
We evaluated the rapid discharge of older patients with reactivated chronic diseases from an acute general hospital to an intermediate care hospital.
A cohort study was carried out. Compliance with predefined quality standards and patient selection were evaluated.
Sixty-eight patients (mean age 82.6 years, 48.5% men) were discharged from the emergency department (69.1%) or medical wards (mean [SD] global length of stay 2.6 [2.9] days in acute wards and 1.5 [1.6] days in the emergency department). Mean post-acute length of stay (SD) was 11.4 (4.2) days. Fifty-six patients (82.4%) were discharged to their previous living situation (home or nursing home), two back to the emergency department, seven to long-term care, and three died. All quality standards were met. In a multivariate analysis, male gender and a higher risk of malnutrition were associated with an increased risk of not returning to the previous living situation (p <0.05).
Intermediate care for selected patients with reactivated chronic diseases might represent an alternative to prolonged acute hospitalization.
我们评估了患有慢性疾病复发的老年患者从急性综合医院快速转至中级护理医院的情况。
开展了一项队列研究。评估了对预定义质量标准的遵守情况和患者选择情况。
68例患者（平均年龄82.6岁，48.5%为男性）从急诊科（69.1%）或内科病房出院（急性病房的平均[标准差]总住院时长为2.6[2.9]天，急诊科为1.5[1.6]天）。急性后期平均住院时长（标准差）为11.4（4.2）天。56例患者（82.4%）出院后回到之前的生活环境（家中或养老院），2例返回急诊科，7例转至长期护理机构，3例死亡。所有质量标准均得到满足。在多变量分析中，男性以及营养不良风险较高与未回到之前生活环境的风险增加相关（p<0.05）。
对选定的慢性疾病复发患者进行中级护理可能是延长急性住院时间的一种替代方案。
