Im Soobin, Lim Da Young, Sohn Min Kyun, Kim Yeongwook
Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea.
Ann Rehabil Med. 2020 Apr;44(2):151-157. doi: 10.5535/arm.2020.44.2.151. Epub 2020 Apr 29.
To characterize the patients in the inpatient rehabilitation facility who were transferred to acute care facilities and identify the frequency of and reasons for the unplanned transfer.
Medical records of patients admitted to the inpatient rehabilitation facility from October 2017 to December 2018 were reviewed. Patients were categorized according to their diagnoses. The included patients were divided into the unplanned transfer and control groups based on whether they required to transfer to another department for acute care before completing an uninterrupted rehabilitation course. The groups were compared in terms of sex, age, length of stay, admission sources, and disease groups. The reasons for unplanned transfers were classified based on medical or surgical conditions.
Of the 1,378 patients were admitted to the inpatient rehabilitation facility, 1,301 satisfied inclusion criteria. Among them, 121 (9.3%) were unexpectedly transferred to the medical or surgical department. The unplanned transfer group had a higher age (69.54±12.53 vs. 64.39±15.32 years; p=0.001) and longer length of stay (85.69±66.08 vs. 37.81±31.13 days; p<0.001) than the control group. The top 3 reasons for unplanned transfers were infectious disease, cardiopulmonary disease, and orthopedic problem.
The unplanned transfer group had a significantly higher age and longer length of stay. The most common reason for the unplanned transfer was infectious disease. However, the proportions of those with orthopedic and neurological problems were relatively high. Therefore, further studies of these patient populations may help organize systematic strategies that are needed to reduce unplanned transfers to acute facilities for patients in rehabilitation facilities.
对转入急症护理机构的住院康复机构患者进行特征描述，并确定非计划转院的频率及原因。
回顾了2017年10月至2018年12月入住住院康复机构的患者的病历。患者根据诊断进行分类。纳入的患者根据在完成不间断康复疗程之前是否需要转至另一科室接受急症护理，分为非计划转院组和对照组。比较两组患者的性别、年龄、住院时间、入院来源和疾病组。非计划转院的原因根据内科或外科情况进行分类。
在1378名入住住院康复机构的患者中，1301名符合纳入标准。其中，121名（9.3%）意外转至内科或外科。非计划转院组的年龄高于对照组（69.54±12.53岁 vs. 64.39±15.32岁；p=0.001），住院时间也更长（85.69±66.08天 vs. 37.81±31.13天；p<0.001）。非计划转院的前三大原因是传染病、心肺疾病和骨科问题。
非计划转院组的年龄显著更高，住院时间更长。非计划转院最常见的原因是传染病。然而，骨科和神经问题患者的比例相对较高。因此，对这些患者群体的进一步研究可能有助于制定系统性策略，以减少康复机构患者非计划转至急症机构的情况。
