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影响日本老年中期护理机构出院患者回家的因素。

Factors influencing users' return home on discharge from a geriatric intermediate care facility in Japan.

作者信息

Ishizaki T, Kai I, Hisata M, Kobayashi Y, Wakatsuki K, Ohi G

机构信息

Department of Public Health, Teikyo University School of Medicine, Tokyo, Japan.

出版信息

J Am Geriatr Soc. 1995 Jun;43(6):623-6. doi: 10.1111/j.1532-5415.1995.tb07195.x.

Abstract

OBJECTIVES

To determine the factors that influence users' destinations on discharge from Geriatric Intermediate Care Facilities (GICFs), which were established in Japan in 1987 to help hospitalized older people return home.

DESIGN

Retrospective chart review.

SETTING

A 94-bed GICF attached to Saku Central Hospital in Japan.

SUBJECTS

Charts of all users (N = 437) aged 65 years and older, discharged from the GICF between July 1987 and February 1991, were reviewed.

MEASUREMENTS

The independent variables, obtained from users' admission records, were age, sex, place of residence before admission, length of stay, intellectual impairment (assessed by Karasawa's diagnostic criteria for senile dementia), ability to perform activities of daily living (ADLs), and living arrangement of users in the GICF. The dependent variable was destination after discharge from the GICF.

MAIN RESULTS

Multiple logistic regression analyses revealed that, compared with users who were able to successfully return home, users with little ability to perform ADLs, male users, and those admitted from other institutions were more likely to be hospitalized. Such analyses also revealed that users who came from institutions, had low ability to perform ADLs, and lived alone were more likely to be institutionalized in nursing homes.

CONCLUSIONS

Evaluating a user's physical, mental, and socioeconomic conditions at an early stage of admission to a GICF may allow us to predict whether the user can be successfully discharged to his or her home or will have to remain in the GICF for an extended period.

摘要

目的

确定影响老年中级护理机构(GICFs)出院使用者去向的因素。这些机构于1987年在日本设立,旨在帮助住院老年人回家。

设计

回顾性病历审查。

地点

日本佐久中央医院附属的一家拥有94张床位的GICF。

研究对象

对1987年7月至1991年2月期间从该GICF出院的所有65岁及以上使用者(N = 437)的病历进行审查。

测量指标

从使用者的入院记录中获取的自变量包括年龄、性别、入院前居住地、住院时间、智力障碍(根据卡拉泽瓦老年痴呆诊断标准评估)、日常生活活动能力(ADLs)以及使用者在GICF中的居住安排。因变量是从GICF出院后的去向。

主要结果

多元逻辑回归分析显示,与能够成功回家的使用者相比,ADLs能力差的使用者、男性使用者以及从其他机构入院的使用者更有可能再次住院。此类分析还显示,来自机构、ADLs能力低且独居的使用者更有可能被安置在养老院。

结论

在使用者入住GICF的早期阶段评估其身体、心理和社会经济状况,可能使我们能够预测该使用者是否能够成功出院回家,或者是否必须在GICF中长期停留。

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