Konings J W, Wendte J F, Danse J A, Ribbe M W
Vrije Universiteit, vakgroep Huisarts- en Verpleeghuisartsgeneeskunde, Amsterdam.
Ned Tijdschr Geneeskd. 1994 Dec 31;138(53):2664-8.
To examine how difficult decisions to hospitalize nursing home patients are considered by the physicians and to what patient characteristics this is related.
Prospective and descriptive.
Analysis of registration data about 387 decisions to hospitalize nursing home patients collected among nursing home physicians in 30 nursing homes.
The degree of difficulty of hospitalisation was associated primarily with poor physical condition and much less with the mental condition. It was not related to patient age (apart from physical condition and the reason for hospitalisation). Referrals were difficult for e.g. infections and respiratory tract disorders, which may be further complicated by the short time available for the decision making because of the life threatening nature of the disorders. With malignancies, feeding, urogenital and skin disorders, decisions to hospitalize also proved difficult to make. These disorders usually allowed more time for consultation.
About half the decisions to hospitalize were considered hard to make. Only when there is better insight into the effects of hospitalisation on patient functioning and quality of life will it be possible to determine correctness and professional obviousness of such decisions.
探讨医生如何看待将养老院患者送医治疗这一艰难决策，以及这与患者的哪些特征相关。
前瞻性描述性研究。
分析从30家养老院的医生处收集的387例将养老院患者送医治疗决策的登记数据。
住院治疗的困难程度主要与身体状况差有关，与精神状况的关联小得多。它与患者年龄无关（除了身体状况和住院原因）。例如，对于感染和呼吸道疾病的转诊很困难，由于这些疾病危及生命，决策时间短可能会使情况进一步复杂化。对于恶性肿瘤、喂养、泌尿生殖系统和皮肤疾病，送医治疗的决策也很困难。这些疾病通常有更多时间进行会诊。
约一半的送医治疗决策被认为难以做出。只有更好地了解住院治疗对患者功能和生活质量的影响，才有可能确定此类决策的正确性和专业性。
