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澳大利亚一家地区医院的痴呆症护理挑战:探索缩短痴呆症患者住院时间的干预措施。

Challenges of Dementia Care in a Regional Australian Hospital: Exploring Interventions to Minimise Length of Stay for Dementia Patients.

作者信息

Reelh Sandeep, Suri Rahul, Hiskens Matthew, Tan Clement, Rana Alok

机构信息

Mackay Hospital and Health Service, Mackay, Queensland, Australia.

出版信息

Aust J Rural Health. 2025 Feb;33(1):e13212. doi: 10.1111/ajr.13212.

Abstract

OBJECTIVE

There are significant difficulties associated with the management of dementia patients in hospitals, leading to adverse patient outcomes, prolonged length of stay (LOS), strain on resources and high readmission rates. This study aimed to investigate these factors in the context of a regional hospital.

DESIGN

This study retrospectively reviewed all dementia admissions in a publicly funded Australian regional hospital from January 2022 to December 2022.

METHODS

All admissions including an ICD-10 coded dementia diagnosis were assessed, and data extracted using the integrated electronic medical record.

SETTING

Overall, 257 bed Australian regional hospital in an area with a Modified Monash Model rating of 2.

PARTICIPANTS

There were 105 dementia patients admitted within the study period.

MAIN OUTCOMES MEASURES

Dementia severity, LOS, consultation liaison (CL) psychiatry involvement, readmission rates, and discharge destinations.

RESULTS

The LOS in patients with dementia was 23.3 (± 35.2) days compared to age-matched patients without dementia admitted in the same period with a LOS of 8.2 (± 4.7) days. Dementia patients who died in hospital had the longest acute LOS at 14.4 (± 8.8) days. Dementia patients who were admitted from their usual residential aged care facility had the longest maintenance LOS at 69 (± 83.3) days.

CONCLUSIONS

This research contributes information to the current knowledge gap of dementia care in regional hospitals. Data from this study may help to inform the development of strategies for effective hospital-based dementia care and interventions.

摘要

目的

医院中痴呆患者的管理存在重大困难,导致患者出现不良后果、住院时间延长、资源紧张和高再入院率。本研究旨在调查一家地区医院的这些因素。

设计

本研究回顾性分析了2022年1月至2022年12月在一家澳大利亚公立地区医院收治的所有痴呆患者。

方法

对所有包含国际疾病分类第十版(ICD-10)编码的痴呆诊断的入院病例进行评估,并使用综合电子病历提取数据。

地点

一家拥有257张床位的澳大利亚地区医院,所在地区的改良莫纳什模型评级为2级。

参与者

研究期间有105名痴呆患者入院。

主要观察指标

痴呆严重程度、住院时间、会诊联络(CL)精神科参与情况、再入院率和出院去向。

结果

痴呆患者的住院时间为23.3(±35.2)天,而同期入院的年龄匹配的非痴呆患者住院时间为8.2(±4.7)天。在医院死亡的痴呆患者急性住院时间最长,为14.4(±8.8)天。从其常住老年护理机构入院的痴呆患者维持住院时间最长,为69(±83.3)天。

结论

本研究为地区医院痴呆护理的当前知识空白提供了信息。本研究的数据可能有助于为制定有效的医院痴呆护理策略和干预措施提供参考。

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