Zimmer J G, Groth-Juncker A, McCusker J
Am J Public Health. 1985 Feb;75(2):134-41. doi: 10.2105/ajph.75.2.134.
This report describes the findings of a randomized study of a new team approach to home care for homebound chronically or terminally ill elderly. The team includes a physician, nurse practitioner, and social worker delivering primary health care in the patient's home, including physician house calls. Weekly team conferences assure coordination of patient care. The team is available for emergency consultation through a 24-hour telephone service. The team physician attends to the patient during necessary hospitalizations. This approach was evaluated in a randomized experimental design study measuring its impact on health care utilization, functional changes in patients, and patient and caretaker satisfaction. The team patients had fewer hospitalizations, nursing home admissions, and outpatient visits than the controls. They were more often able to die at home, if this was their wish. As expected, they used more in-home services, measured in weighted cost figures; their overall cost was lower than their controls, but the difference was not statistically significant. Their functional abilities did not change differently from the controls, but they, and especially their informal caretakers in the home, expressed significantly higher satisfaction with the care received.
本报告描述了一项针对居家慢性或晚期老年患者的新型家庭护理团队方法的随机研究结果。该团队包括一名医生、一名执业护士和一名社会工作者，他们在患者家中提供初级医疗保健服务，包括上门问诊。每周的团队会议确保患者护理的协调。通过24小时电话服务，团队随时提供紧急咨询。团队医生在患者必要住院期间进行照料。该方法在一项随机实验设计研究中进行了评估，测量其对医疗保健利用、患者功能变化以及患者和照料者满意度的影响。与对照组相比，团队护理的患者住院次数、养老院入住次数和门诊就诊次数更少。如果患者有此意愿，他们更有可能在家中离世。正如预期的那样，以加权成本数据衡量，他们使用了更多的居家服务；他们的总体成本低于对照组，但差异无统计学意义。他们的功能能力与对照组相比没有不同变化，但他们，尤其是家中的非正式照料者，对所接受的护理表示出明显更高的满意度。
