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老年人卒中患者在两种不同基层医疗环境中接受整合照护 6 个月后的健康相关结局。

Health-related outcomes 6 months after integrated care of older people with stroke in 2 different primary care settings.

机构信息

Department of Gynecology & Obstetrics, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.

Department of Rehabilitation, The Seventh Affiliated Hospital, Southern Medical University, Foshan, China.

出版信息

Fam Pract. 2024 Jun 12;41(3):299-304. doi: 10.1093/fampra/cmad021.

Abstract

BACKGROUND

Integrated care has been proven to be effective among stroke survivors. However, in China, these services mainly focus on connecting the healthcare system (acute, primary medical, and skilled) at the individual level. Closer health and social care integration is a new concept.

OBJECTIVE

This study aimed to compare health-related outcomes 6 months after the implementation of the 2 integrated care models.

METHODS

It was a 6-month follow-up of an open, prospectively study comparing the outcomes of a model of integrated health and social care (IHSC) versus a usual integrated healthcare (IHC) model. Outcomes were measured by Short-Form Health Survey-36 (SF-36), Modified Barthel Index (MBI), and Caregiver Strain Index (CSI) at 3 and 6 months, respectively.

RESULTS

There were no statistically significant differences in MBI scores between patients in the 2 models either after 3 months or at the end of intervention. The same trend was not seen in Physical Components Summary, an integral component of SF-36. Patients in IHSC model scored statistically significant higher points in Mental Components Summary, another integral part of SF-36 than patients in IHC model after 6 months. Average scores of CSI were statistically significant lower for IHSC model than for IHC model after 6 months.

CONCLUSION

The findings suggest the need to improve the scales of integration and recognize the vital role played by social care services when designing or improving an integrated care for older people with stroke.

摘要

背景

综合护理已被证明对中风幸存者有效。然而,在中国,这些服务主要侧重于在个人层面上连接医疗保健系统(急性、初级医疗和熟练)。更紧密的医疗和社会保健整合是一个新概念。

目的

本研究旨在比较实施 2 种综合护理模式 6 个月后的健康相关结果。

方法

这是一项为期 6 个月的开放性、前瞻性研究的随访,比较了综合卫生和社会保健(IHSC)模式与常规综合医疗保健(IHC)模式的结果。分别在 3 个月和 6 个月时使用简明健康调查量表 36 项版(SF-36)、改良巴氏指数(MBI)和照顾者负担量表(CSI)测量结果。

结果

在 3 个月或干预结束时,2 种模式患者的 MBI 评分均无统计学差异。SF-36 的一个组成部分,生理成分综合评分,也没有出现同样的趋势。IHSC 模式患者的 SF-36 中的心理成分综合评分在 6 个月后比 IHC 模式患者的得分显著更高。6 个月后,IHSC 模式的 CSI 平均评分显著低于 IHC 模式。

结论

这些发现表明需要改进整合标准,并在设计或改进老年人中风综合护理时,认识到社会保健服务所起的重要作用。

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