上海市老年护理院出入院标准试运行研究

发布时间：2018-05-24 22:30

  本文选题：老年护理院 + 出入院　； 参考：《上海交通大学学报(医学版)》2016年04期

【摘要】：目的结合国内外地区经验和国内具体情况,拟定《上海市老年护理院出入院标准》并评估其真实性与可行性。方法通过文献综述、问卷调查及专家访谈拟定《上海市老年护理院出入院标准》,并将该标准转换成系统软件。对上海地区26家老年护理机构中的住院患者进行医师评估和软件系统评估,分析标准评估与医师评估结果的一致性,并计算标准评估的敏感度和特异度。分析上海地区老年护理机构住院患者人群分布特点。结果 Kappa一致性检验显示,标准评估结果与医师评估结果 Kappa值为0.931(P=0.006)。以医师评估为金标准,计算标准评估敏感度和特异度,分别为98.40%(95%CI 98.03%～98.76%)和96.20%(95%CI 95.15%～97.26%)。对上海地区老年护理机构住院患者人群分布特点进行分析,结果显示,应当出院或转院但仍住院的老年患者中郊区患者比例高于市区(P=0.000),通过社保支付的患者比例明显高于其他支付方式(P=0.016),干部人群比例明显高于其他职业人群(P=0.004);独立社区卫生中心收治符合标准的患者情况最佳,达到84.1%。分析住院患者罹患疾病,发现糖尿病患者不符合住院标准者比例最高,达32.4%。结论《上海市老年护理院出入院标准》能较真实、客观、有效地评价上海地区老年患者是否符合老年护理院出入院标准。
[Abstract]:Objective to draw up the standard of entrance and exit of Shanghai geriatric nursing home and evaluate its authenticity and feasibility according to regional and domestic experience and domestic specific conditions. Methods through literature review, questionnaire survey and expert interview, the standard of entrance and exit of Shanghai geriatric nursing home was drawn up, and the standard was converted into system software. 26 elderly in Shanghai area were used. The hospitalized patients in the nursing institution were evaluated by doctors and software system, the consistency between the standard evaluation and the results of the physician evaluation was analyzed, and the sensitivity and specificity of the standard evaluation were calculated. The distribution characteristics of the inpatient population in the elderly nursing institutions in Shanghai were analyzed. Results the results of Kappa one test showed that the standard evaluation results and the physician evaluation were evaluated. The Kappa value of the estimated results was 0.931 (P=0.006). According to the physician evaluation as the gold standard, the standard evaluation sensitivity and specificity were calculated, 98.40% (95%CI 98.03% ~ 98.76%) and 96.20% (95%CI 95.15% to 97.26%). The distribution characteristics of the hospitalized patients in the elderly nursing institutions in Shanghai were analyzed. The results showed that the hospital should be discharged or transferred but still hospitalized. The proportion of elderly patients in the middle suburban area was higher than that of the urban area (P=0.000). The proportion of patients paid through social security was significantly higher than that of other payment methods (P=0.016). The proportion of cadres was significantly higher than that of other occupational groups (P=0.004). The best cases of patients who were admitted to the standard in the independent community health center were the best, and 84.1%. analysis of hospitalized patients suffered from disease. The proportion of diabetic patients who do not conform to the standard of hospitalization is the highest, and the standard of entry and exit of the elderly patients in the Shanghai area is evaluated objectively and effectively by the 32.4%. conclusion "the standard of the entrance and exit of the Shanghai elderly nursing home."
【作者单位】： 上海交通大学公共卫生学院;上海市人口和计划生育宣教中心;
【分类号】：R197.3
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本文编号：1930869