Dollard J, Harvey G, Dent E, Trotta L, Williams N, Beilby J, Hoon E, Kitson A, Seiboth C, Karnon J
Joanne Dollard, Basil Hetzel Institute, The Queen Elizabeth Hospital, 28 Woodville Rd, Woodville, SA 5011 Australia, T +618 8222 7349, F +618 8222 7872, Email:
J Frailty Aging. 2018;7(3):193-195. doi: 10.14283/10.14283/jfa.2018.12.
Older frequent users of acute care can experience fragmented care. There is a need to understand the issues in a local context before attempting to address fragmented care. 0.5% (n=61) of the population in a defined local government area were identified as having ≥4 unplanned emergency department (ED) presentations/ admissions to an acute-care hospital over 13 months. A retrospective case-series study was conducted to examine detailed pathways of care for 17 patients within the identified population. The two dominant presentation reasons were clinical symptoms associated with a declining/significant loss of capacity in fundamental self-care activities and chronic cardiac/respiratory conditions. Of patients discharged home, 21% of discharge letters were delayed >7 days and only 19% received a written discharge plan. Half of community dwelling patients received home nursing and/or assistance. Frequent users of acute care can experience untimely hospital communication and may require more coordinated care provided in the community to assist self-care and manage chronic conditions.
急性护理的老年频繁使用者可能会经历碎片化护理。在尝试解决碎片化护理问题之前，有必要在当地背景下了解相关问题。在一个特定的地方政府区域，0.5%（n = 61）的人口被确定在13个月内有≥4次无计划的急诊科就诊/入住急性护理医院。进行了一项回顾性病例系列研究，以检查该特定人群中17名患者的详细护理路径。两个主要就诊原因是与基本自我护理活动能力下降/显著丧失相关的临床症状以及慢性心脏/呼吸疾病。出院回家的患者中，21%的出院信延迟超过7天，只有19%的患者收到了书面出院计划。一半的社区居住患者接受了家庭护理和/或援助。急性护理的频繁使用者可能会经历医院沟通不及时的情况，可能需要在社区提供更协调的护理，以协助自我护理和管理慢性病。
