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采取随机抽样的方法对133例计划外过早再入院的老年患者进行了研究,并与未再入院的患者进行了比较。通过与病人、他们的护理人、病房护士、病人的主管医生进行交谈,搞清每个患者计划外过早再入院的原因。发现七个可能存在的主要原因:原病复发、患了新的疾病、护理问题、由最初病症引起的并发症、需要晚期护理、药物及服务问题。计划外再入院率为6%;计划内为3%。作者认为78例(59%)计划外再入院患者是可以避免的。研究组与对照组之间在以下方面存在明显差异:低收入、住院史、护理条件、被开业医生收治入院情况。这些因素有助于发现有可能再次急诊入院患者。二十年来出现了不少有关老年病人出院问题的研究报道。多数作者叙述了他们重新安置这些出院病人的困难。评论的一个问题是计划外再入院。出院后第一年内再入院率高达20%。东西区(1979年)65岁以上病人再入院率为15%。三分之一的再入院患者是于出院后28天内再入院的。研究对象大多限于从老年医学科出院的病人或患有某种特殊残疾的老年病人。这项研究旨在了解患者的出院过程、搞清引起计划外过早再入院的原因。
A random sampling method was used to study 133 elderly patients who had been prematurely re-admitted unplanned and compared with patients who were not re-admitted. Through conversations with patients, their caregivers, ward nurses, and the patient’s competent doctors, the reasons for each patient’s premature rehospitalization outside the plan were identified. Seven possible causes were identified: recurrence of the original disease, new disease, nursing problems, complications from the initial condition, need for advanced care, drugs and services. The rate of unplanned re-admission is 6%; within the plan, it is 3%. The authors conclude that 78 patients (59%) who had unplanned readmissions could be avoided. There were significant differences between the study group and the control group in the following areas: low income, history of hospitalization, nursing conditions, admission to hospital by a medical practitioner. These factors help to find patients who may be urgently admitted to hospital again. In the past 20 years, there have been many reports on the discharge of elderly patients. Most authors describe their difficulties in resettling these discharged patients. One of the problems with the review was that it was re-admitted to the hospital. In the first year after discharge, the rate of re-admission was as high as 20%. In the Eastern and Western Districts (1979), the rate of re-admission among patients over the age of 65 was 15%. One-third of re-admission patients were re-admitted within 28 days of discharge. Most of the studies were limited to patients who were discharged from geriatrics or elderly patients with a specific disability. The purpose of this study was to understand the patient’s discharge process and to identify the reasons for premature rehospitalization.