Leite Homero Teixeira, Manhães Alex C, Antunes Luisa A, Chan Tevy, Hajj-Boutros Guy, Morais José A
Prevent Senior, Av. Jorge Curi, 550-Bloco A-Sala 186-Barra da Tijuca, Rio de Janeiro 22611-202, Brazil.
Department of Physiological Science, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Avenida Marechal Rondon, 381, São Francisco Xavier, Rio de Janeiro 0950-000, Brazil.
Healthcare (Basel). 2022 Oct 29;10(11):2160. doi: 10.3390/healthcare10112160.
(1) Background: Older adults comprise a large proportion of hospitalized patients. Many are frail and require complex care. Geriatrics has developed models of care specific to this inpatient population. Our objective was to demonstrate the effect of a geriatric co-management team on clinical administrative indicators of care in Clinical Teaching Units (CTUs) that have adopted the Age-friendly Hospital (AFH) principles in Brazilian hospitals. (2) Methods: Following 3 months of implementation of the AFH principles in CTUs, two periods of the same 6 months of two consecutive years were compared. (3) Results: The total number of participants in the study was 641 and 743 in 2015 and 2016, respectively. Average length of patient-stay (length of stay: 8.7 ± 2.7 vs. 5.4 ± 1.7 days) and number of monthly complaints (44.2 ± 6.5 vs. 13.5 ± 2.2) were significantly lower with the co-management model. Number of homecare service referrals/month was also significantly higher (2.5 ± 1 vs. 38.3 ± 6.3). The 30-day readmission rates and total hospital costs per patient remained unchanged. (4) Conclusion: The presence of a geriatric co-management team in CTUs is of added benefit to increase the efficiency of the AFH for vulnerable older inpatients with reduced LOS and increased referrals to homecare services without increasing hospital costs.
(1) 背景：老年人在住院患者中占很大比例。许多老年人身体虚弱，需要复杂的护理。老年医学已针对这一住院人群开发了护理模式。我们的目标是证明老年共同管理团队对巴西医院中采用友善医院（AFH）原则的临床教学单元（CTU）的临床管理护理指标的影响。(2) 方法：在CTU实施AFH原则3个月后，对连续两年相同的6个月的两个时间段进行比较。(3) 结果：2015年和2016年研究参与者总数分别为641人和743人。采用共同管理模式时，患者平均住院时间（住院时间：8.7±2.7天对5.4±1.7天）和每月投诉数量（44.2±6.5对13.5±2.2）显著降低。每月家庭护理服务转诊数量也显著增加（2.5±1对38.3±6.3）。30天再入院率和每位患者的总住院费用保持不变。(4) 结论：CTU中存在老年共同管理团队有助于提高AFH对脆弱老年住院患者的效率，可缩短住院时间并增加家庭护理服务转诊，同时不增加医院成本。
