[长期护理患者中按护理阶段和护理环境划分的发病率差异：一项基于索赔数据的研究结果]
[Morbidity differences according to nursing stage and nursing setting in long-term care patients: Results of a claims data based study].
作者信息
Heinen I, van den Bussche H, Koller D, Wiese B, Hansen H, Schäfer I, Scherer M, Schön G, Kaduszkiewicz H
机构信息
Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
出版信息
Z Gerontol Geriatr. 2015 Apr;48(3):237-45. doi: 10.1007/s00391-013-0556-y.
BACKGROUND
We analyzed the differences in morbidity patterns of chronic diseases between long-term care dependent persons in nursing homes compared to those dwelling in the community. We also investigated morbidity differences between long-term care need stages in Germany.
MATERIALS AND METHODS
The study included claims data of one nationwide operating statutory health insurance in 2006. Inclusion criteria were age ≥ 65 years, minimum 1 out of 46 diagnoses in at least 3 quarters of the year (n = 8,670). A comparison population was formed with n = 114,962. Prevalences, relative risks, and odds ratios for the risk of nursing home care were calculated.
RESULTS
In the bivariate analysis, only three chronic diseases - dementia, urinary incontinence, and chronic heart failure - showed a higher risk for nursing home care. Regression analysis revealed that only dementia showed higher odds related to the stage of nursing needs.
CONCLUSION
Among the chronic diseases, only dementia shows a substantially elevated risk for nursing home care. Risk studies on other chronic diseases associated with higher risks of long-term care dependency and specific intervention strategies aiming at delaying or preventing nursing home admission should be developed.
背景
我们分析了养老院中依赖长期护理的人群与社区居住人群之间慢性病发病模式的差异。我们还调查了德国不同长期护理需求阶段的发病差异。
材料与方法
该研究纳入了2006年一家全国性运营的法定健康保险的理赔数据。纳入标准为年龄≥65岁，一年中至少三个季度有46种诊断中的至少1种（n = 8,670）。形成了一个对照人群，n = 114,962。计算了养老院护理风险的患病率、相对风险和比值比。
结果
在双变量分析中，只有三种慢性病——痴呆、尿失禁和慢性心力衰竭——显示出更高的养老院护理风险。回归分析表明，只有痴呆与护理需求阶段相关的比值更高。
结论
在慢性病中，只有痴呆显示出养老院护理风险大幅升高。应开展针对与长期护理依赖高风险相关的其他慢性病的风险研究以及旨在延迟或预防入住养老院的特定干预策略。
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