Hung Chen-Yu, Wu Wei-Ting, Chang Ke-Vin, Wang Tyng-Guey, Han Der-Sheng
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital BeiHu Branch, Taipei, Taiwan.
Community and Geriatric Medicine Research Center, National Taiwan University Hospital BeiHu Branch, Taipei, Taiwan.
PLoS One. 2017 Aug 23;12(8):e0183612. doi: 10.1371/journal.pone.0183612. eCollection 2017.
The Chinese version of the Continuity Assessment Record and Evaluation (CARE-C) item set was developed to facilitate the assessment of post-acute care (PAC) patients in Taiwan. Considering that the length of hospital stay (LOS) has a significant effect on the total healthcare cost, determining whether the CARE-C scores could predict the LOS of PAC patients is of great interest to the PAC providers.
This prospective trial included PAC patients with stroke or central nervous system injuries. The demographic data and CARE-C scores were collected after admission and before discharge. A multivariable stepwise linear regression model was used to identify the predictors of the LOS using age, sex, tube placement status, CARE-C component scores at admission, and score differences between admission and discharge as independent variables.
This study included 178 patients (66 women and 112 men), with a mean age of 61.9 ± 15.6 years. Indwelling urinary catheter placement status at admission (β = 0.241, p = 0.002) was a positive predictor of the LOS, whereas age (β = -0.189, p = 0.010), core transfer subscale score at admission (β = -0.176, p = 0.020), and difference in continence subscale score (β = -0.203, p = 0.008) were negative predictors of the LOS. The model explained 14% of the total variance.
Indwelling urinary catheter placement status at admission, age, core transfer subscale score at admission, and difference in the CARE-C continence subscale score were identified as predictors of the LOS. The explanatory power of these predictors might be limited due to the regulations of Taiwan's National Health Insurance.
中文版连续性评估记录与评价（CARE-C）项目集旨在促进对台湾地区急性后护理（PAC）患者的评估。考虑到住院时间（LOS）对总医疗费用有重大影响，确定CARE-C评分能否预测PAC患者的住院时间对PAC提供者来说具有极大的研究价值。
这项前瞻性试验纳入了患有中风或中枢神经系统损伤的PAC患者。在入院后和出院前收集人口统计学数据和CARE-C评分。使用多变量逐步线性回归模型，以年龄、性别、导管放置状态、入院时的CARE-C分量表评分以及入院与出院之间的评分差异作为自变量，来确定住院时间的预测因素。
本研究纳入了178例患者（66名女性和112名男性），平均年龄为61.9±15.6岁。入院时留置导尿管的放置状态（β = 0.241，p = 0.002）是住院时间的正向预测因素，而年龄（β = -0.189，p = 0.010）、入院时核心转移子量表评分（β = -0.176，p = 0.020）以及失禁子量表评分差异（β = -0.203，p = 0.008）是住院时间的负向预测因素。该模型解释了总方差的14%。
入院时留置导尿管的放置状态、年龄、入院时核心转移子量表评分以及CARE-C失禁子量表评分差异被确定为住院时间的预测因素。由于台湾地区国民健康保险的规定，这些预测因素的解释力可能有限。
