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[初级家庭护理中人群的发病率及医疗资源利用情况]

[Morbidity and use of healthcare resources of people in Primary Home Care].

作者信息

Medina Peralta Manuel, Torres Marta, Guananga David, Poltorak Violeta, Sánchez-Coll Sergi, Espallargues Mireia

机构信息

Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, España.

Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, España.

出版信息

Aten Primaria. 2025 Jun 21;57(11):103276. doi: 10.1016/j.aprim.2025.103276.

Abstract

OBJECTIVE

To describe health status and health care services of the people included in home care program (HC) through secondary use of data from the public system.

DESIGN

Observational population-based study.

LOCATION

Primary health care in Catalonia (2022).

PARTICIPANTS

All people over 65 years of age included in HC matched 1:1 with people not attended in HC by age, sex, socioeconomic level and primary care team (45,578 persons per group, 70.5% women and mean age 86.8 years).

INTERVENTIONS

People receiving HC.

MAIN MEASUREMENTS

Morbidity, healthcare use and events (hospital admissions, mortality).

RESULTS

53.6% of people in HC had a diagnosis of complex chronic patient and 5.7% of advanced chronic disease, compared to 1.1% and 0.05% in the non-HC population. There were more people in HC with heart failure, dementia, stroke, auricular fibrillation and COPD, with higher drug use and pharmaceutical expenditure (€1,446 vs. €732, ratio 1.98, 95%CI 1.95-2.00). Mortality was 20% in HC and 6% in the non-HC population (ratio 3.3, 95%CI 3.17-3.44). A stratified analysis by age showed a higher complexity, morbidity and events in people between 65 and 80 years of age with respect to those over 80 years of age in HC.

CONCLUSIONS

The results, which show increased morbidity and complexity in HC, especially in people under 80 years of age, may be useful to better identify care needs of these people and program planning.

摘要

目的

通过对公共系统数据的二次利用,描述居家护理项目(HC)所涵盖人群的健康状况和医疗服务情况。

设计

基于人群的观察性研究。

地点

加泰罗尼亚的初级医疗保健(2022年)。

参与者

所有纳入HC的65岁以上人群,按年龄、性别、社会经济水平和初级保健团队与未接受HC的人群进行1:1匹配(每组45578人,女性占70.5%,平均年龄86.8岁)。

干预措施

接受HC的人群。

主要测量指标

发病率、医疗服务利用情况和事件(住院、死亡率)。

结果

HC人群中53.6%被诊断为复杂慢性病患者,5.7%为晚期慢性病,而非HC人群中这一比例分别为1.1%和0.05%。HC人群中心力衰竭、痴呆、中风、心房颤动和慢性阻塞性肺疾病患者更多,药物使用和药品支出更高(1446欧元对732欧元,比值1.98,95%置信区间1.95 - 2.00)。HC人群死亡率为20%,非HC人群为6%(比值3.3,95%置信区间3.17 - 3.44)。按年龄分层分析显示,HC中65至80岁人群相较于80岁以上人群,疾病复杂性、发病率和事件发生率更高。

结论

结果表明HC人群发病率和复杂性增加,尤其是80岁以下人群,这可能有助于更好地确定这些人群的护理需求和规划项目。

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