老年人高风险癌症手术后一年的离家时间。
Time Spent Away from Home in the Year Following High-Risk Cancer Surgery in Older Adults.
机构信息
Department of Urology, University of California, San Francisco, California.
Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
出版信息
J Am Geriatr Soc. 2020 Mar;68(3):505-510. doi: 10.1111/jgs.16344. Epub 2020 Jan 25.
OBJECTIVES
To understand where older adults spend time (at home, in the hospital, or in a nursing home) in the year following high-risk cancer surgery.
DESIGN
Retrospective cohort study.
SETTING
Medicare beneficiaries using data from Medicare Inpatient claims to ascertain hospital days and the Minimum Data Set to ascertain nursing home days.
PARTICIPANTS
Beneficiaries who underwent high-risk cancer surgery (cystectomy, pancreaticoduodenectomy, gastrectomy, or esophagectomy) were identified to determine cumulative time spent away from home in the year following surgery.
MEASUREMENTS
Adjusted percentages of time spent away from home (ie, days in a hospital or nursing home) were modeled for the year following surgery.
RESULTS
A total of 37 748 beneficiaries underwent high-risk cancer surgery during the study period, and 28.3% died within 1 year. Overall, beneficiaries spent 13.9 ± 26.2 days in the hospital (over 1.5 ± 2.0 hospital readmissions) and 37.2 ± 50.6 days in the nursing home (over 1.5 ± 1.0 admissions) in the year following surgery. Among beneficiaries who were alive and dead at 1 year, 18.5% and 30.1% of time was spent away from home, respectively. Beneficiaries who were initially discharged to a facility following surgery and died within 1 year spent 44.4% of their final year away from home.
CONCLUSION
Time spent away from home in the hospital and/or nursing home in the year following high-risk cancer surgery is substantial among Medicare beneficiaries. This information is crucial in counseling patients on postoperative expectations and may additionally influence preoperative decision making. J Am Geriatr Soc 68:505-510, 2020.
目的
了解高风险癌症手术后患者在一年内的时间分配（居家、住院或养老院）。
设计
回顾性队列研究。
地点
使用医疗保险住院记录确定住院天数，使用最低数据集确定养老院天数，以确定医疗保险受益人的数据。
参与者
接受高风险癌症手术（膀胱切除术、胰十二指肠切除术、胃切除术或食管切除术）的患者，以确定术后一年内离家时间的累积。
测量
对术后一年内离家时间（即住院或养老院天数）的调整百分比进行建模。
结果
在研究期间，共有 37748 名患者接受了高风险癌症手术，其中 28.3%在 1 年内死亡。总体而言，患者在术后一年内住院 13.9±26.2 天（1.5±2.0 次住院再入院），在养老院住院 37.2±50.6 天（1.5±1.0 次入院）。在存活和死亡 1 年的患者中，分别有 18.5%和 30.1%的时间不在家。手术后最初被送往医疗机构且在 1 年内死亡的患者，有 44.4%的时间不在家。
结论
在高风险癌症手术后的 1 年内，医疗保险受益人在医院和/或养老院的离家时间相当多。这些信息对于术后预期的患者咨询至关重要，并且可能会影响术前决策。美国老年学会杂志 68：505-510，2020 年。
Zotero 插件