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[专科老年门诊患者的剖析]

[Profiling of patients in a specialized geriatric outpatient clinic].

作者信息

Rohde Jörg Martin, Kunnel Asha, Becker Ingrid, Unger Heinz L, Hummel Jana, Röhrig-Herzog Gabriele

机构信息

MVZ Medicum Köln-Ost, Zentrum für spezialisierte geriatrische Diagnostik, Johann Classen Strasse 68, 51103, Köln, Deutschland.

Klinik für neurologische und fachübergreifende Frührehabilitation, St Marien Hospital, Köln, Deutschland.

出版信息

Z Gerontol Geriatr. 2023 Aug;56(5):402-407. doi: 10.1007/s00391-022-02059-x. Epub 2022 May 6.

Abstract

BACKGROUND

In Germany geriatric outpatient care is predominantly done by family doctors and general practitioners (GP). There are regionally different concepts for additional specialized geriatric outpatient care but they have not yet been validated and established. Still, it remains unclear whether a geriatric patient has to be diagnosed rather in a specialized outpatient or inpatient setting. The aim of the present study is the profiling of geriatric outpatients to find key distinctions from geriatric patients that have to be admitted to hospital.

METHODS

Retrospective data analysis of patients sent to a specialized geriatric outpatient clinic by their GP, compared with data of geriatric inpatients sent to hospital by their GP during the same time period. Study parameters comprised elements of the comprehensive geriatric assessment as well as results of routinely applied laboratory tests.

RESULTS

Patients sent to the specialized geriatric outpatient clinic showed better results of functional assessments. Regression analysis: improvement of Barthel Index, GFR and total protein increased the chance of outpatient treatment.

CONCLUSION

Early identification of geriatric patients who can be treated in a specialized outpatient setting would ease the burden for GPs by interdisciplinary cooperation and prevent cost-intensive readmissions to hospital.

摘要

背景

在德国,老年门诊护理主要由家庭医生和全科医生(GP)提供。对于额外的专业老年门诊护理,存在地区差异的概念,但尚未得到验证和确立。然而,老年患者究竟更适合在专业门诊还是住院环境中进行诊断仍不明确。本研究的目的是对老年门诊患者进行剖析,以找出与必须住院的老年患者的关键区别。

方法

对由全科医生转诊至专业老年门诊的患者进行回顾性数据分析,并与同期由全科医生转诊至医院的老年住院患者的数据进行比较。研究参数包括综合老年评估的要素以及常规实验室检查的结果。

结果

转诊至专业老年门诊的患者功能评估结果更好。回归分析表明:Barthel指数、肾小球滤过率(GFR)和总蛋白的改善增加了门诊治疗的机会。

结论

早期识别可在专业门诊环境中治疗的老年患者,将通过跨学科合作减轻全科医生的负担,并防止成本高昂的再次住院。

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