Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
NPJ Prim Care Respir Med. 2020 Sep 8;30(1):39. doi: 10.1038/s41533-020-00196-7.
In this study, we compare health status between COPD patients treated in three different care levels in the Netherlands and assess determinants that influence their health status. We applied the Nijmegen Clinical Screening Instrument to measure eight health status subdomains in primary (n = 289), secondary (n = 184) and tertiary care (n = 433) COPD patient cohorts. Proportions of patients with severe problems in ≥3 subdomains are 47% in primary, 71% in secondary and 94% in tertiary care. Corrected for patient characteristics, differences between the care levels are statistically significant for nearly all health status subdomains. The pooled cohort data show female sex, age, FEV % predicted and BMI to be determinants of one or more subdomains. We conclude that the proportion of COPD patients with severe health status problems is substantial, not just in tertiary care but also in primary and secondary care. Use of detailed health status information may support patient-tailored COPD care.
在这项研究中，我们比较了在荷兰接受三种不同护理水平治疗的 COPD 患者的健康状况，并评估了影响其健康状况的决定因素。我们应用尼梅亨临床筛选工具测量了初级护理（n=289）、二级护理（n=184）和三级护理（n=433）COPD 患者队列中的八个健康状况子领域。≥3 个子领域存在严重问题的患者比例分别为初级护理组的 47%、二级护理组的 71%和三级护理组的 94%。校正患者特征后，几乎所有健康状况子领域的护理水平差异均具有统计学意义。综合队列数据显示，女性、年龄、FEV%预测值和 BMI 是一个或多个子领域的决定因素。我们得出结论，严重健康状况问题的 COPD 患者比例相当大，不仅在三级护理中，而且在初级和二级护理中也是如此。使用详细的健康状况信息可能有助于为 COPD 患者提供个体化的护理。
