Szczerbińska Katarzyna, Topinková Eva, Brzyski Piotr, van der Roest Henriette G, Richter Tomáš, Finne-Soveri Harriet, Denkinger Michael D, Gindin Jacob, Onder Graziano, Bernabei Roberto
Unit for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.
Department of Geriatrics, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
J Am Med Dir Assoc. 2016 Sep 1;17(9):807-13. doi: 10.1016/j.jamda.2016.05.003. Epub 2016 Jun 21.
To describe health care and preventive service provision to nursing home (NH) residents with diabetes mellitus (DM) and to analyze factors determining use of selected services.
In the period between 2009 and 2011, the Services and Health for Elderly in Long TERm care (SHELTER) project, a 12-month prospective cohort study, was conducted to assess 4037 NH residents aged 60 years and older residing in 59 NHs in 7 European countries and Israel.
The InterRAI tool for long-term care facilities was used to assess care needs and provided health care services. Descriptive statistics and multivariate logistic regression were applied to describe differences between NH residents with (DR) and without DM (non-DR), and to find factors determining use of services and care provided to both groups.
DR more often than non-DR were hospitalized (18.2% vs 14.3%) and required rehabilitation (23.8% vs 18.2%) or clinically complex care (15.9% vs 13.7%). They also more frequently received a repositioning program (26.8% vs 22.7%), a wound care (15.1% vs 9.8%), and some preventive services as yearly eye examination (41.0% vs 35.9%), pneumococcal vaccination (33.5% vs 26.6%), mammography in women (12.1% vs 7.4%), and colonoscopy (5.6% vs 3.6%). Yet, rates of some of them (mammography, colonoscopy, hearing and dental examinations) were very low in both study cohorts with exception of annual influenza vaccination (82.1%) and yearly blood pressure checkup (95.0%). Interestingly, DM enhanced odds only for mammography [odds ratio (OR) 1.55, 95% confidence interval [CI] 1.15-2.09, P = .004) and eye examination (OR 1.21, 95% CI 1.03-1.42; P = .018).
DR more frequently receive care related to DM clinical complexity; nevertheless, the recommended frequency of preventive procedures is not met both in DR and non-DR.
描述为患有糖尿病（DM）的养老院（NH）居民提供的医疗保健和预防服务，并分析决定某些服务使用情况的因素。
在2009年至2011年期间，开展了长期护理中的老年人服务与健康（SHELTER）项目，这是一项为期12个月的前瞻性队列研究，旨在评估居住在7个欧洲国家和以色列的59家养老院中的4037名60岁及以上的NH居民。
使用针对长期护理机构的InterRAI工具来评估护理需求并提供医疗保健服务。应用描述性统计和多变量逻辑回归来描述患有DM（DR）和未患有DM（非DR）的NH居民之间的差异，并找出决定为两组提供的服务和护理使用情况的因素。
与非DR相比，DR更常住院（18.2%对14.3%），需要康复治疗（23.8%对18.2%）或临床复杂护理（15.9%对13.7%）。他们也更频繁地接受重新定位计划（26.8%对22.7%）、伤口护理（15.1%对9.8%）以及一些预防服务，如年度眼部检查（41.0%对35.9%）、肺炎球菌疫苗接种（33.5%对26.6%）、女性乳房X线摄影（12.1%对7.4%）和结肠镜检查（5.6%对3.6%）。然而，除了年度流感疫苗接种（82.1%）和年度血压检查（95.0%）外，其中一些服务（乳房X线摄影、结肠镜检查、听力和牙科检查）在两个研究队列中的发生率都非常低。有趣的是，DM仅增加了乳房X线摄影[优势比（OR）1.55，95%置信区间[CI] 1.15 - 2.09，P = 0.004]和眼部检查（OR 1.21，95% CI 1.03 - 1.42；P = 0.018）的几率。
DR更频繁地接受与DM临床复杂性相关的护理；然而，DR和非DR均未达到推荐的预防程序频率。
