School of Nursing, University of Texas, Austin, TX 78701-1499, USA.
J Telemed Telecare. 2013 Feb;19(2):107-12. doi: 10.1258/jtt.2012.120509. Epub 2013 Mar 25.
Data from homecare electronic health records were used to explore the association of patient characteristics with re-hospitalizations of patients with heart failure (HF) during a 60-day period of telemonitoring following hospital discharge. Data from 403 Medicare patients with HF who had used telehealth from 2008 to 2010 were analysed. There were 112 all-cause (29%) and 73 cardiac-related (19%) re-hospitalizations within 60 days of the start of telemonitoring. In adjusted analyses, the patients' number of medications and type of cardiac medications were significantly (P < 0.05) associated with an increased risk of re-hospitalization. After stratifying the sample by illness severity, age and gender, other significant (P < 0.05) predictors associated with an increased risk of all-cause and cardiac re-hospitalization were psychiatric co-morbidity, pulmonary and obesity co-morbidities within gender, beta blocker prescription in females and primary HF diagnosis in the oldest age stratum. The study's findings may assist homecare agencies seeking to allocate resources without compromising patient care.
利用家庭医疗电子健康记录中的数据，探索了在出院后进行 60 天远程监测期间，患者特征与心力衰竭（HF）患者再次住院之间的关联。对 2008 年至 2010 年期间使用远程医疗的 403 名医疗保险 HF 患者的数据进行了分析。在远程监测开始后的 60 天内，有 112 例（29%）和 73 例（19%）为全因（非心脏原因）和心脏相关原因的再住院。在调整分析中，患者用药数量和心脏用药类型与再住院风险增加显著相关（P<0.05）。对样本按疾病严重程度、年龄和性别分层后，与全因和心脏再住院风险增加显著相关的其他重要预测因素（P<0.05）为性别中的精神合并症、肺部和肥胖合并症、女性β受体阻滞剂处方以及最年长年龄组中的原发性 HF 诊断。该研究结果可能有助于家庭护理机构在不影响患者护理的情况下分配资源。
