Victor C R, Vetter N J
Research Team for Care of the Elderly, University of Wales College of Medicine, St. Davids Hospital, Cardiff, UK.
Arch Gerontol Geriatr. 1989 Jan;8(1):87-94. doi: 10.1016/0167-4943(89)90073-3.
Despite the fact that the elderly are a major client group of the hospital service, there has been comparatively little investigation of outcome for this client group after discharge. In this paper the difficulties in recording outcome for the elderly are discussed, using the example of a survey based in Wales. A 4% random sample of patients aged 65 years and over discharged from NHS non-psychiatric hospitals in Wales during 1981 were sent a postal questionnaire 3 months after discharge. Response rates of over 80% were achieved. Outcome after discharge was measured by 3 indices: mortality, physical disability, and patients' own assessments of their health status and rehabilitation. Of survivors, 35% were more disabled than before admission, and 43% did not feel that they were fully rehabilitated. All measures of outcome were strongly inter-correlated and demonstrate a clear trend to deteriorate with increased time after discharge. Interpretation of these results remains difficult until measures of cost and benefit are developed. Without these it is not possible to determine if the results reported are better (or worse) than would be expected given the level of resources involved.
尽管老年人是医院服务的主要客户群体，但出院后针对该客户群体的结果调查相对较少。本文以威尔士的一项调查为例，讨论了记录老年人结果的困难。1981年从威尔士国民保健服务非精神病医院出院的65岁及以上患者的4%随机样本在出院3个月后收到了一份邮政问卷。回复率超过80%。出院后的结果通过三个指标衡量：死亡率、身体残疾以及患者对自身健康状况和康复情况的评估。在幸存者中，35%的人比入院前残疾更严重，43%的人觉得自己没有完全康复。所有结果指标之间都高度相关，并显示出出院后时间越长恶化趋势越明显。在制定成本和效益衡量标准之前，对这些结果的解释仍然很困难。没有这些标准，就无法确定所报告的结果与考虑到所涉及资源水平时预期的结果相比是更好（还是更差）。
