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[德国医院对认知障碍老年人的出院管理——一项范围综述]

[Discharge management in German hospitals for cognitively impaired, older people-a scoping review].

作者信息

Schumacher-Schönert F, Wucherer D, Nikelski A, Kreisel S, Vollmar H C, Hoffmann W, Thyrian J R

机构信息

AG Interventionelle Versorgungsforschung, Deutsches Zentrum für Neurodegenerative Erkrankungen e. V. (DZNE) Standort Rostock/Greifswald, Ellernholzstr. 1-2, 17487, Greifswald, Deutschland.

Evangelisches Klinikum Bethel gGmbH, Akademisches Lehrkrankenhaus, Universität Münster, Münster, Deutschland.

出版信息

Z Gerontol Geriatr. 2021 Nov;54(7):695-703. doi: 10.1007/s00391-020-01732-3. Epub 2020 May 7.

Abstract

BACKGROUND

In German hospitals approximately 40% of all patients over the age of 65 years are cognitively impaired (MmkB). After discharge from hospital it is particularly important for MmkB that the transition to domestic life is organized as seamlessly and as well-coordinated as possible.

OBJECTIVE

The aim of the study was to determine the existing evidence on discharge management (EM) in MmkB and people with dementia (MmD). Furthermore, the study examined the necessity of an intersectoral concept for MmkB.

MATERIAL AND METHODS

Based on a scoping review a total of 102 publications were identified, of which 6 articles were finally used for the evaluation.

RESULTS

The article provides an overview of the current care of MmkB in acute care hospitals in Germany. General information on EM in hospitals was given in three of the six publications included. Information on special discharge and care management for MmkB and MmD was contained in five out of six papers.

DISCUSSION

The article illustrates significant gaps in the hospital care for older MmkB, in particular at the interface of discharge management and demonstrates the need for new care models. To what extent these new care models can be structurally, procedurally and systemically embedded in the standard care and financed, is an open and unexplored question.

摘要

背景

在德国医院,65岁以上的患者中约40%存在认知障碍(MmkB)。出院后,对于存在认知障碍的患者而言,尽可能无缝且协调地过渡到家庭生活尤为重要。

目的

本研究旨在确定有关存在认知障碍的患者(MmkB)和痴呆症患者(MmD)出院管理(EM)的现有证据。此外,该研究还探讨了针对存在认知障碍的患者制定跨部门概念的必要性。

材料与方法

基于范围综述,共识别出102篇出版物,其中最终有6篇文章用于评估。

结果

本文概述了德国急性护理医院中目前对存在认知障碍的患者的护理情况。纳入的6篇出版物中有3篇给出了医院出院管理的一般信息。6篇论文中有5篇包含了有关存在认知障碍的患者和痴呆症患者特殊出院及护理管理的信息。

讨论

本文揭示了医院对老年存在认知障碍的患者护理方面的重大差距,尤其是在出院管理的衔接方面,并表明需要新的护理模式。这些新的护理模式在多大程度上能够在结构、程序和系统上融入标准护理并获得资金支持,是一个尚未探讨的开放性问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d89/8551109/ff4d5b2dcb2c/391_2020_1732_Fig1_HTML.jpg

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