Improving hospital outcomes in patients admitted from residential aged care: results from a controlled trial

被引:16
作者
Mudge, Alison Mary [1 ,2 ]
Denaro, Charles P. [1 ,2 ]
O'Rourke, Peter [3 ]
机构
[1] Royal Brisbane & Womens Hosp, Brisbane, Qld 4029, Australia
[2] Univ Queensland, Sch Med, Brisbane, Qld, Australia
[3] Queensland Inst Med Res, Herston, Qld 4006, Australia
关键词
residential aged care; nursing home; interdisciplinary care; elderly; NURSING-HOME RESIDENTS; LONG-TERM-CARE; FUNCTIONAL OUTCOMES; OLDER PATIENTS; EMERGENCY-DEPARTMENT; GERIATRIC EVALUATION; RANDOMIZED-TRIAL; INTERVENTION; INPATIENT; UNIT;
D O I
10.1093/ageing/afs045
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Objective: to identify the impact of an interdisciplinary care model on medical inpatients admitted from residential aged care (RAC). Design: pre-planned subgroup analysis of controlled trial. Setting: general medical units of a teaching hospital in Brisbane, Australia. Subjects: consecutive patients aged over 65 admitted from RAC (n = 189) or the community (n = 815). Methods: all admitted general medical patients were allocated by existing cyclical roster to control (usual care) or intervention units (interdisciplinary care consisting of improved allied health staffing, consistent teams, daily team meetings and early discharge planning). Patient characteristics and outcomes of care were compared between RAC and community subgroups. In the RAC subgroup, outcomes were compared between the control and intervention groups. Results: patients admitted from RAC had much higher in-hospital mortality (13 versus 6%) and 6-month mortality (35 versus 17%) than those from community. RAC residents receiving the intervention had a significant reduction in in-hospital mortality (4 versus 22% P < 0.001) sustained at 6 months (28 versus 44% P = 0.02). Conclusions: poor hospital outcomes for RAC residents may reflect prevailing models of inpatient care.
引用
收藏
页码:670 / 673
页数:4
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