Namdaran F, Sherval J
Department of Public Health Medicine, Edinburgh.
Health Bull (Edinb). 1995 Nov;53(6):373-8.
Five surveys carried out in Edinburgh nonpsychiatric general hospitals between 1988 and 1994 have shown a progressive drop in the number of elderly patients (65 and over) waiting for long stay care. The overall point prevalence rate has fallen from 21.2% in 1988 to 9.2% in 1994. All three specialty categories (Geriatric Assessment, Geriatric Orthopaedic and General Medical) which have high prevalences have shown falls with the largest fall occurring in General Medical beds from 13.4% in 1988 to 3.8% in 1994. A substantial percentage (61.6%) of patients surveyed in 1994 were waiting to go into Private Nursing Homes which is in stark contrast to 8.5% in 1988, whereas the reverse has happened with those waiting for NHS Geriatric Long Stay care falling from 75% to 12.8%. It appears that the Community Care legislation has accelerated the shift toward Private Nursing Home care but has not, as feared, increased the number of old people waiting for long stay care in Edinburgh hospitals. The number of elderly patients awaiting long stay care in acute general medical beds in Edinburgh has now reached acceptable levels. If the same trend is occurring elsewhere in Scotland, we believe that attention should now turn to monitoring inappropriate early discharge of elderly patients.
1988年至1994年间在爱丁堡非精神科综合医院进行的五项调查显示,等待长期护理的老年患者(65岁及以上)数量呈逐步下降趋势。总体时点患病率已从1988年的21.2%降至1994年的9.2%。所有三个高患病率的专科类别(老年评估、老年骨科和普通内科)均呈现下降趋势,其中普通内科病床的下降幅度最大,从1988年的13.4%降至1994年的3.8%。1994年接受调查的患者中有相当比例(61.6%)等待入住私立疗养院,这与1988年的8.5%形成鲜明对比,而等待国民保健制度老年长期护理的患者比例则从75%降至12.8%。社区护理立法似乎加速了向私立疗养院护理的转变,但并未像人们担心的那样,增加爱丁堡医院等待长期护理的老年人数量。爱丁堡急性普通内科病床中等待长期护理的老年患者数量现已达到可接受水平。如果苏格兰其他地区也出现同样的趋势,我们认为现在应将注意力转向监测老年患者不适当的过早出院情况。