老年人生命最后一年的住院护理：一项基于人群的研究。
Hospital care for the elderly in the final year of life: a population based study.
作者信息
Henderson J, Goldacre M J, Griffith M
机构信息
Unit of Clinical Epidemiology, University of Oxford.
出版信息
BMJ. 1990 Jul 7;301(6742):17-9. doi: 10.1136/bmj.301.6742.17.
OBJECTIVES
To determine whether among people aged 65 and over those who died at advanced old age spent more of their last year of life in hospital than those who died younger, and whether the increase in longevity in the elderly between 1976 and 1985 was accompanied by increased time spent in hospital in the last year of life.
DESIGN
Linkage of death records to abstracts of records of hospital inpatient care in the preceding year of patients' lives.
SETTING
Six health districts in England covered by the Oxford record linkage study.
RESULTS
People who died at advanced ages (85 and over) were less likely than people who died at younger ages (65-84) to have been admitted to hospital in the last year of life. Once admitted the very old tended to spend longer in hospital than others. The mean total time spent in hospital by the elderly in the year before death (based on all deaths including those among people not admitted at all) showed no appreciable change over time. The median time in hospital based on all deaths increased by about three days between 1976 and 1985. During that time there was a gain in life expectancy in the population of about one year from the age of 65.
CONCLUSION
The gain in life expectancy in this population was not at the expense of any substantial increase in time spent in hospital in the final year of life.
目的
确定65岁及以上人群中，高龄去世者在生命最后一年的住院时间是否比低龄去世者更长，以及1976年至1985年间老年人预期寿命的增加是否伴随着生命最后一年住院时间的增加。
设计
将死亡记录与患者生前上一年的医院住院护理记录摘要相联系。
背景
牛津记录链接研究覆盖的英格兰六个健康区。
结果
高龄（85岁及以上）去世者在生命最后一年入院的可能性低于低龄（65 - 84岁）去世者。一旦入院，高龄者往往比其他人在医院停留的时间更长。老年人在死亡前一年的平均住院总时间（基于所有死亡情况，包括那些根本未入院者）随时间没有明显变化。基于所有死亡情况的住院时间中位数在1976年至1985年间增加了约三天。在此期间，65岁及以上人群的预期寿命增加了约一岁。
结论
该人群预期寿命的增加并非以生命最后一年住院时间的大幅增加为代价。
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