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The ecology of medical care.医疗保健生态学
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Determining how much medical care we need.确定我们需要多少医疗护理。
N Engl J Med. 1980 Nov 27;303(22):1292-3. doi: 10.1056/NEJM198011273032209.
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The patient record in epidemiology.流行病学中的患者记录。
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A statistical analysis of the relationship of physical status to postoperative mortality in 68,388 cases.对68388例患者身体状况与术后死亡率关系的统计分析。
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Risk of surgery in patients over 90.
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Selection bias in the referral of patients and the natural history of surgical conditions.患者转诊中的选择偏倚与外科疾病的自然史。
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8
Sharing increasing costs on declining income: the visible dilemma of the invisible aged.收入下降却要分担不断增加的成本:隐形老年人面临的明显困境。
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ASA physical status classifications: a study of consistency of ratings.美国麻醉医师协会身体状况分类:评级一致性研究
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90岁及以上人群的外科手术。明尼苏达州奥尔姆斯特德县1975 - 1985年的一项基于人群的研究。

Surgical procedures among those greater than or equal to 90 years of age. A population-based study in Olmsted County, Minnesota, 1975-1985.

作者信息

Warner M A, Hosking M P, Lobdell C M, Offord K P, Melton L J

机构信息

Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905.

出版信息

Ann Surg. 1988 Apr;207(4):380-6. doi: 10.1097/00000658-198804000-00003.

DOI:10.1097/00000658-198804000-00003
PMID:3258506
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1493434/
Abstract

Persons greater than or equal to 90 years of age represent a rapidly growing subset of the population, but little data exist on their utilization of the health care system. Population-based data capabilities of the Rochester/Olmsted County Epidemiology Project were used to study the performance of surgery among persons greater than or equal to 90 years of age for the 11-year period, 1975-1985. During this time, 224 residents of Olmsted County, Minnesota underwent 301 separate operations. The annual operation rate increased over the course of the study (trend test, p less than 0.001), reaching a plateau of 89.0 per 1000 person-years. This suggests a potential for nearly 91,000 operations annually in this age group based on 1987 U.S. Census estimates. Ninety-two per cent were discharged from the hospital alive, and 5-year survival was consistent with that expected (23% vs. 17%). Increased longevity of the general population, combined with increased performance of surgery in this rapidly growing segment of the population, may have significant implications for health care planning.

摘要

90岁及以上的人群在总人口中所占比例正在迅速增长,但关于他们对医疗保健系统的利用情况的数据却很少。罗切斯特/奥姆斯特德县流行病学项目基于人群的数据能力被用于研究1975年至1985年这11年间90岁及以上人群的手术情况。在此期间,明尼苏达州奥姆斯特德县的224名居民接受了301次不同的手术。在研究过程中,年手术率有所上升(趋势检验,p<0.001),达到每1000人年89.0例的平稳水平。根据1987年美国人口普查估计,这表明该年龄组每年可能有近91000例手术。92%的患者出院时存活,5年生存率与预期相符(23%对17%)。总体人群寿命的延长,加上在这一快速增长的人群中手术量的增加,可能对医疗保健规划产生重大影响。