Hoffmann Falk, Habbinga Kirsten
Department für Versorgungsforschung, Carl von Ossietzky Universität Oldenburg, Ammerländer Heerstr. 140, 26129, Oldenburg, Deutschland.
Pius-Hospital, Medizinischer Campus der Carl von Ossietzky Universität Oldenburg, Oldenburg, Deutschland.
Med Klin Intensivmed Notfmed. 2023 Oct;118(7):549-555. doi: 10.1007/s00063-022-00952-2. Epub 2022 Sep 7.
The number of emergency department (ED) visits in Germany continues to increase, especially by older people and persons receiving care.
We aimed to characterize ED visits by nursing home residents (NHR) in Germany.
We analyzed routine data of a hospital without trauma surgery (Pius-Hospital Oldenburg). All ED visits by NHR in the period 06/2014-05/2017 were selected from the hospital information system.
Of 47,270 ED visits, 1676 (3.6%) were NHR (mean age: 78.8 years; 62.9% women; 40.3% were referred). Of them, 20.1% were on weekends and 80.6% occurred between 8 am-8 pm. A total of 84.2% visits led to hospitalization; the length of stay was 1 day for 21.1% and 2-3 days for another 14.6%. With longer length of stay, the proportion of admissions by referring physicians increased. Of those admitted, 10.3% died during hospitalization (28.2% on the day of admission; 47.9% within the first 3 days). People who died were older, their visits were more frequently on weekends, and they were less often referred.
Our study reveals problems in several areas. Improved interprofessional cooperation with general practitioners and strengthened palliative structures should be implemented in nursing homes. Furthermore, there is a need for establishing processes in EDs to realize continued outpatient care for these patients.
德国急诊科就诊人数持续增加，尤其是老年人和接受护理的人群。
我们旨在描述德国养老院居民在急诊科的就诊情况。
我们分析了一家无创伤外科的医院（奥尔登堡皮乌斯医院）的常规数据。从医院信息系统中选取了2014年6月至2017年5月期间养老院居民的所有急诊科就诊记录。
在47270次急诊科就诊中，1676次（3.6%）是养老院居民（平均年龄：78.8岁；62.9%为女性；40.3%是被转诊的）。其中，20.1%在周末就诊，80.6%发生在上午8点至晚上8点之间。总共84.2%的就诊导致住院治疗；住院时间为1天的占21.1%，2至3天的占另外14.6%。住院时间越长，转诊医生的收治比例越高。在那些住院的患者中，10.3%在住院期间死亡（入院当天死亡的占28.2%；前3天内死亡的占47.9%）。死亡的患者年龄更大，他们的就诊更频繁地发生在周末，且被转诊的情况较少。
我们的研究揭示了几个方面的问题。养老院应加强与全科医生的跨专业合作并强化姑息治疗体系。此外，急诊科需要建立相关流程，以实现对这些患者的持续门诊护理。
