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[痴呆症对急性护理医院住院时间和费用的影响]

[Impact of dementia on length of stay and costs in acute care hospitals].

作者信息

Motzek Tom, Junge Michael, Marquardt Gesine

机构信息

Emmy Noether-Nachwuchsgruppe "Architektur im Demografischen Wandel", Professur für Sozial- und Gesundheitsbauten, Institut für Gebäudelehre und Entwerfen, Fakultät Architektur, Universität Dresden, Dresden, Deutschland.

, Dresden, Deutschland.

出版信息

Z Gerontol Geriatr. 2017 Jan;50(1):59-66. doi: 10.1007/s00391-016-1040-2. Epub 2016 Apr 18.

Abstract

BACKGROUND

The treatment of patients with dementia in acute care hospitals is becoming increasingly more important. The aim of this study was to investigate and demonstrate aspects of the healthcare situation and resource consumption of dementia patients during their hospital stay in a ward for internal medicine.

MATERIAL AND METHODS

Secondary data from a ward of internal medicine were analyzed on a retrospective and case-related basis. For 100 patients a diagnosis of dementia by a general practitioner before hospitalization was identified. The control group was selected by age and sex from the other patients in the ward (n = 100). The costs were calculated on the basis of the German diagnosis-related groups (G-DRG) flat rate case classification. The relationship between dementia, deviation from the average length of stay and costs was investigated under the control of comorbidities using multivariate regression analysis.

RESULTS

Patients with dementia had poorer health at admission with respect to functionality and orientation and a higher risk of falls and pressure ulcers. During hospitalization patients with dementia fell more frequently than patients without dementia (12 % versus 3 %, p = 0.029). Regarding the average length of stay, according to the G‑DRG catalogue patients with dementia stayed 1.4 days longer in hospital than patients without dementia and caused excess costs of 19 %.

CONCLUSION

Patients with dementia are a highly vulnerable patient group with a higher consumption of resources than patients without dementia. The results demonstrate the care-related and economic consequences, which the increasing number of patients with dementia could have in the future.

摘要

背景

在急症医院中,痴呆症患者的治疗变得越来越重要。本研究的目的是调查并展示痴呆症患者在内科病房住院期间的医疗状况和资源消耗情况。

材料与方法

对内科病房的二级数据进行回顾性和病例相关性分析。确定了100名在住院前由全科医生诊断为痴呆症的患者。对照组根据年龄和性别从病房中的其他患者中选取(n = 100)。成本根据德国诊断相关分组(G-DRG)统一费率病例分类进行计算。在控制合并症的情况下,使用多变量回归分析研究痴呆症、平均住院时间偏差与成本之间的关系。

结果

痴呆症患者入院时在功能和定向方面的健康状况较差,跌倒和压疮风险较高。住院期间,痴呆症患者比非痴呆症患者跌倒更频繁(12% 对 3%,p = 0.029)。关于平均住院时间,根据G-DRG目录,痴呆症患者的住院时间比非痴呆症患者长1.4天,导致成本超支19%。

结论

痴呆症患者是一个高度脆弱的患者群体,比非痴呆症患者消耗更多资源。结果表明,未来痴呆症患者数量的增加可能会带来与护理相关的经济后果。

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