Booth B M, Blow F C, Ludke R L, Ross R L
VA Medical Center, North Little Rock, AR 72114, USA.
J Ment Health Adm. 1996 Fall;23(4):366-74. doi: 10.1007/BF02521022.
This study indicates that the majority of patients admitted to VA hospitals for medical detoxification could have those services provided on an outpatient or less intensive basis. However, inpatient medical detoxification services appear to be appropriate for those alcoholics at risk for potential life-threatening complications of withdrawal such as delirium tremens, or those with concurrent associated medical conditions such as pancreatitis, gastrointestinal bleeding, or complications of cirrhosis. Data were obtained from a national random sample of hospitalizations in Department of Veterans Affairs (VA) inpatient medical and surgical units. Medical records for 144 alcoholism-related medical admissions to 35 VA medical centers were reviewed using the Appropriateness Evaluation Protocol (AEP), a clinically based utilization review instrument widely used in the private sector. The medical records for the admission and each day of medical/surgical inpatient stay were reviewed using clinical criteria for the appropriateness of acute inpatient care as opposed to lower levels of care.
这项研究表明，大多数因药物脱瘾而入住退伍军人管理局（VA）医院的患者，其这些服务可以在门诊或强度较低的基础上提供。然而，住院药物脱瘾服务似乎适用于那些有戒断潜在危及生命并发症风险的酗酒者，如震颤谵妄，或那些同时患有相关内科疾病的患者，如胰腺炎、胃肠道出血或肝硬化并发症。数据来自退伍军人事务部（VA）住院内科和外科病房的全国随机抽样住院病例。使用适当性评估方案（AEP）对35个VA医疗中心144例与酒精中毒相关的内科住院病例的病历进行了审查，AEP是一种在私营部门广泛使用的基于临床的利用审查工具。使用急性住院护理适当性的临床标准，而不是较低级别的护理标准，对入院病历以及内科/外科住院期间的每一天病历进行了审查。
