Jones E W, Densen P M, Brown S D
Harvard Center for Community, Health and Medical Care, MA.
Health Serv Res. 1989 Dec;24(5):643-64.
In a study of 737 elderly hospital patients discharged to their homes in suburban areas northwest of Chicago, Illinois, 60 percent were assessed as needing help with personal care or housekeeping. Only 19 percent were referred by the hospital to community service agencies and, in the immediate postdischarge period, a large proportion of help in both personal care and housekeeping was given by relatives. Eight months after discharge, however, the proportion of care provided by relatives had decreased and the proportion of paid help had increased. The use of help at both points in time was strongly related to limitations in the basic activities of daily living (ADL) at time of hospital discharge. Many patients were unaware of available community services, and 64 percent said that no one in the hospital had talked with them about managing at home. These findings indicate the need for rethinking criteria for hospital discharge planning, more effective communication between service providers and patients, and community focus of attention on elders coming home from the hospital.
在一项针对伊利诺伊州芝加哥市西北郊区737名出院回家的老年住院患者的研究中，60%的患者被评估为需要个人护理或家务帮助。医院仅将19%的患者转介至社区服务机构，并且在出院后的短期内，个人护理和家务方面的大部分帮助是由亲属提供的。然而，出院八个月后，亲属提供护理的比例下降，付费帮助的比例上升。这两个时间点的帮助使用情况与出院时日常生活基本活动（ADL）受限密切相关。许多患者并不知晓可用的社区服务，64%的患者表示医院里没人与他们谈论过居家管理事宜。这些发现表明，有必要重新思考医院出院计划的标准、服务提供者与患者之间更有效的沟通，以及社区对出院回家老人的关注重点。
