Strauss D, Shavelle R, Baumeister A, Anderson T W
Department of Statistics, University of California, Riverside 92521, USA.
Am J Ment Retard. 1998 May;102(6):569-81. doi: 10.1352/0895-8017(1998)102<0569:mipwdd>2.0.co;2.
More than 2,000 persons with developmental disabilities have been transferred from California state institutions into community care in recent years. We investigated whether this has been accompanied by a change in mortality rates, using data on 1,878 clients moved since April 1993. Mortality rates were compared to those expected for comparable persons in institutions. Risk-adjusted mortality rates for movers exceeded institutional rates by 51%, p < .05. After removal of cancer deaths in both groups, this increased to 67%. The effect was largest shortly after the move and in the subjects who had moved most recently. The deinstitutionalization process in California appears to have resulted in a substantial increase in mortality, indicating the need to ensure continuous, consistent, and competent medical care and supervision in the community.
近年来，2000多名发育障碍患者已从加利福尼亚州的机构转移至社区护理机构。我们利用1993年4月以来转移的1878名患者的数据，调查了这一情况是否伴随着死亡率的变化。将这些患者的死亡率与机构中类似患者的预期死亡率进行了比较。转移患者的风险调整死亡率比机构中的死亡率高出51%，p < .05。在去除两组中的癌症死亡病例后，这一比例增至67%。这种影响在转移后不久以及最近转移的患者中最为明显。加利福尼亚州的非机构化进程似乎导致了死亡率的大幅上升，这表明需要确保在社区中提供持续、一致且有效的医疗护理和监督。
