在美国急诊科接受护理的老年人住院相关因素。
Factors Associated With Hospital Admission for Older Adults Receiving Care in U.S. Emergency Departments.
作者信息
Lo Alexander X, Flood Kellie L, Biese Kevin, Platts-Mills Timothy F, Donnelly John P, Carpenter Christopher R
机构信息
Department of Emergency Medicine.
Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine, University of Alabama at Birmingham.
出版信息
J Gerontol A Biol Sci Med Sci. 2017 Aug 1;72(8):1105-1109. doi: 10.1093/gerona/glw207.
BACKGROUND
Emergency departments (EDs) play a growing role in hospital admissions for older adults, yet nationally representative data on predictors of admission from the EDs are limited.
METHODS
We examined sociodemographic, clinical, and hospital characteristics associated with non-ICU admissions, using National Hospital Ambulatory Medical Care Survey data and multivariate Poisson regression models.
RESULTS
There were an estimated 175 million ED visits by adults older than 65 years from 2001 to 2010. Overall, 32.5% were admitted to non-ICU beds. In multivariate analysis, non-ICU admission was associated with increasing age (16% higher per 10-year increase in age), white versus black race (35% vs 31%), and EDs in the Northeast (40%) or Midwest (38%) versus South (31%) or West (30%).
CONCLUSION
Non-ICU admission rates for older adults receiving care in U.S. EDs vary by age, race, and region. Understanding the reasons for these disparities in hospitalization rates may guide interventions to reduce hospitalizations in older adults.
背景
急诊科在老年患者住院治疗中所起的作用日益重要，但关于急诊科住院预测因素的全国代表性数据有限。
方法
我们利用国家医院门诊医疗调查数据和多变量泊松回归模型，研究了与非重症监护病房（non-ICU）住院相关的社会人口统计学、临床和医院特征。
结果
2001年至2010年期间，65岁以上成年人估计有1.75亿次急诊就诊。总体而言，32.5%的患者被收治到非重症监护病房。在多变量分析中，非重症监护病房住院与年龄增长（每增加10岁，住院率高16%）、白人种族与黑人种族（35%对31%）以及东北部（40%）或中西部（38%）的急诊科与南部（31%）或西部（30%）的急诊科有关。
结论
在美国急诊科接受治疗的老年人非重症监护病房住院率因年龄、种族和地区而异。了解这些住院率差异的原因可能有助于指导采取干预措施，以减少老年人的住院率。
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