Vecchio Nerina
Griffith Health Institute, Griffith Business School, Gold Coast Mail Centre, Australia.
Aust Health Rev. 2013 Jun;37(3):356-61. doi: 10.1071/AH13011.
To identify characteristics associated with the likelihood of a client receiving a referral to the Home and Community Care (HACC) program from various sources.
Data were collected from 73809 home care clients during 2007-08. Binary logistic and multinomial logistic regression were used to investigate the likelihood of a client being referred by health workers v. non-health workers.
Females and clients cared for by their parents were less likely to receive referrals from health workers than non-health workers after confounding variables were controlled for. While poorer functional ability of clients increased the probability of receiving a referral from a health worker, the opposite was true for those with behavioural problems. Over 43% of the sample either self-referred or was referred by family or friends.
Eligible individuals may miss out on services unless they or their family take the initiative to refer. There is a need for improved methods and incentives to support and encourage health workers to refer eligible individuals to the program. What is known about the topic? The absence or inappropriate referral to a suitable home care program can place pressure on formalised institutions and increase burdens on family members and the community. Factors largely unrelated to healthcare needs carry significant weight in determining hospital discharge decisions and home care referrals by practitioners. What does this paper add? The effectiveness of the HACC program is dependent on the referrer who acts to inform and facilitate individuals to the program. The purpose of this study is to identify the characteristics associated with the likelihood of individuals receiving a referral to the HACC program from various sources. What are the implications for practitioners? This study will assist policy makers and practitioners in developing effective strategies that transition individuals to suitable home care services in a timely manner. An effective referral process would provide opportunities for implementing preventative strategies that reduce disability rates among individuals and the burden of care for the community. For instance, individuals with unmet needs may be at higher risk from injury at home through inadequate monitoring of nutrient and medication intake and inappropriate home surroundings. Improving knowledge about care options and providing appropriate incentives that encourage health workers to refer individuals would be an effective start in improving the health outcomes of an ageing population.
确定与客户从不同来源获得转介至居家与社区护理（HACC）项目可能性相关的特征。
收集了2007 - 2008年期间73809名居家护理客户的数据。使用二元逻辑回归和多项逻辑回归来研究客户由卫生工作者转介与非卫生工作者转介的可能性。
在控制混杂变量后，女性以及由父母照顾的客户比非卫生工作者转介的客户更不可能从卫生工作者处获得转介。虽然客户较差的功能能力增加了从卫生工作者处获得转介的可能性，但有行为问题的客户情况则相反。超过43%的样本是自我转介或由家人或朋友转介。
符合条件的个体可能会错过服务，除非他们或其家人主动进行转介。需要改进方法和激励措施，以支持和鼓励卫生工作者将符合条件的个体转介至该项目。关于该主题已知什么？缺乏或不恰当转介至合适的居家护理项目会给正规机构带来压力，并增加家庭成员和社区的负担。在决定医院出院决策和从业者的居家护理转介方面，很大程度上与医疗需求无关的因素具有重要影响。本文补充了什么？HACC项目的有效性取决于转介者，转介者负责告知并协助个体参与该项目。本研究的目的是确定与个体从不同来源获得转介至HACC项目可能性相关的特征。对从业者有何启示？本研究将协助政策制定者和从业者制定有效的策略，以便及时将个体过渡到合适的居家护理服务。有效的转介过程将为实施预防策略提供机会，从而降低个体的残疾率和社区的护理负担。例如，需求未得到满足的个体可能因对营养和药物摄入监测不足以及居家环境不合适而在家中受伤的风险更高。提高对护理选择的认识并提供适当激励措施以鼓励卫生工作者转介个体，将是改善老年人口健康结局的有效开端。
