Sánchez-Pérez Inma, Comes Garcia Nuri, Romero Piniella Lola, Prats Martos Gemma, Arnau Bataller Gemma, Coderch Jordi
Grup de Recerca en Serveis Sanitaris i Resultats en Salut (GRESSIRES), Serveis de Salut Integrats Baix Empordà (SSIBE), Palamós (Girona), España.
Centro Sociosanitario Palamós Gent Gran, Serveis de Salut Integrats Baix Empordà (SSIBE), Palamós (Girona), España.
Gac Sanit. 2018 Jan-Feb;32(1):27-34. doi: 10.1016/j.gaceta.2016.11.005. Epub 2017 Feb 10.
Hospital emergencies (HE) arising from nursing homes (NH) are on the rise. We analyse the evolution, characteristics and appropriateness of HE of NH residents in a region, as well as resulting hospital admissions.
Retrospective descriptive study between 2010 and 2013 of institutionalised residents of 11 NH located in Baix Empordà (704 beds) and Palamós Hospital.
Gender, age, morbidity and relative weight according to clinical risk groups (CRG), NH, length of stay, diagnosis of the emergency, appropriateness of HE according to Bermejo's criteria and the HE appropriateness protocol (HEAP), and appropriateness of hospitalisations according to the Appropriateness Evaluation Protocol (AEP). Sample to evaluate appropriateness: 159 HE and 91 hospitalisations.
frequency, mean, standard deviation, percentiles, Fisher's exact test and ANOVA, with a confidence interval of 95% and using IBM SPSS Statistics 23.
1,474 people were enrolled, of which 73% were women. Group ≥85 years increased to 60.3% and the mean weight of morbidity was 3.2 to 4.0 (p <0.001). 1,805 HE were generated. The annual rate per 1,000 stays arising from NH increased from 1.64 to 2.05, of which 90.6% were appropriate according to Bermejo's criteria and 93.7% according to the HEAP. Of these, 502 involved hospitalisation. The annual rate per 10 emergencies fell from 2.96 to 2.64 and 98.9% were appropriate according to the AEP.
Hospital emergencies and hospitalisations of NH residents are increasing and are appropriate. Increasing age and disease burden could explain this phenomenon. NH and hospitals should react appropriately, considering the specific needs of this population sector.
养老院引发的医院急诊数量呈上升趋势。我们分析了某地区养老院居民医院急诊的演变、特征及合理性，以及由此导致的住院情况。
对位于baix Empordà（704张床位）的11家养老院和帕拉莫斯医院的机构化居民进行2010年至2013年的回顾性描述性研究。
性别、年龄、发病率以及根据临床风险组（CRG）划分的相对权重、养老院、住院时间、急诊诊断、根据贝梅霍标准和医院急诊合理性协议（HEAP）判断的医院急诊合理性，以及根据合理性评估协议（AEP）判断的住院合理性。评估合理性的样本：159例医院急诊和91例住院病例。
频率、均值、标准差、百分位数、费舍尔精确检验和方差分析，置信区间为95%，使用IBM SPSS Statistics 23软件。
共纳入1474人，其中73%为女性。85岁及以上人群占比增至60.3%，平均发病权重为3.2至4.0（p<0.001）。共产生1805例医院急诊。养老院每1000次住院产生的年急诊率从1.64增至2.05，其中根据贝梅霍标准，90.6%的急诊合理，根据HEAP标准，93.7%的急诊合理。其中，502例涉及住院。每10例急诊的年住院率从2.96降至2.64，根据AEP标准，98.9%的住院合理。
养老院居民的医院急诊和住院情况呈上升趋势且合理。年龄增长和疾病负担加重可能解释了这一现象。养老院和医院应考虑这一人群的特殊需求，做出适当反应。
