摘要
目的 通过对上海市徐家汇街道社区卫生服务中心家庭医生团队照护模式与普通居家养老的对比研究,探讨家庭医生团队服务减少居家养老的失能老人发生肺炎、褥疮等并发症的风险.方法 2014年2月至2015年1月,选择上海市徐家汇街道86例居家养老患者,随机分成实验组和对照组,各43例.实验组患者由家庭医生团队提供长期、全方位、一体化照顾,对照组不采取干预措施,随访3、6和12个月,比较两组患者并发症发生率及再次人院情况.结果 随访6个月时,两组失能老人褥疮[4.9% (2/41)比28.9%(11/38),x2=8.311]、肺炎[2.4%(1/41)比21.1%(8/38),x2=6.769]和深静脉栓塞发生率[2.4%(1/41)比15.8% (6/38),x2=4.353]比较,差异均有统计学意义(均P <0.05);12个月时,褥疮[2.4%(1/41)比42.1% (16/38),x2=18.374]、肺炎[4.9% (2/41)比28.9%(11/38),x2=8.311]和深静脉栓塞发生率[7.3% (3/41)比28.9%(11/38),x2=6.328]比较,差异均有统计学意义(均P <0.05).两组失能老人的褥疮痊愈(6/7比0,x2=18.555)、褥疮恶化(0比11/16,x2 =9.224)、肺炎痊愈[5/6比4.3%(1/23),x2=18.092]、肺炎恶化[0比52.2%(12/23),x2=5.340]发生率比较,差异有统计学意义(均P <0.05);两组深静脉栓塞好转(1/3比0,x2=3.949)、恶化(0比8/11,x2=5.091)发生率比较,差异有统计学意义(均P<0.05).两组居家患者再人院率[2.4%(1/41)比36.8%(14/38),x2=15.175]、并发症患者再入院率[1/12比43.8%(14/38),x2=4.872]比较,差异均有统计学意义(P<0.05).结论 家庭医生团队服务模式可减少居家养老的失能老人发生并发症的几率,减少患者再次住院的次数,提高居家养老患者的生命质量,减轻家庭及社会负担.
Objective To assess the effect of family doctor team care on morbidity of disabled elderly in home care.Methods Eighty six disabled elderly patients with home care in Shanghai Xujiahui community were enrolled from February 2014 to January 2015.The patients were randomly divided into intervention group and control group with 43 cases in each.In intervention group,the family doctor team provided long-term,comprehensive and integrated care,and in control group the conventional home care was provided.The rates of morbidity and readmission to hospital were documented during the 3,6 and 12 monthfollow-up,and compared between two groups.Results The incidence rates of bedsore,pneumonia and deep vein thrombosis in intervention group was significantly lower than those in control group [after 6 months:4.9% (2/41) vs.28.9%(11/38),x2 =8.311;2.4% (1/41) vs.21.1% (8/38),x2 =6.769;2.4% (1/41) vs.15.8% (6/38),x2 =4.353,respectively;after 12 months:2.4% (1/41) vs.42.1% (16/38),x2 =18.374;4.9% (2/41)vs.28.9% (11/38),x2 =8.311;7.3% (3/41)vs.28.9% (11/38),x2 =6.328,respectively;all P <0.05].The number of cases with bedsore healing(6/7 vs.0,x2 =18.555)and pneumonia recovery[5/6 vs.4.3% (1/23),x2 =18.092] was significantly more and that with pneumonia deterioration (0 vs.52.2% (12/23),x2 =5.340)was significantly less in intervention group than those in control group (all P < 0.05).More cases with deep vein thrombosis improved(1/3 vs.0,x2 =3.949) and less cases with deep vein thrombosis deteriorated(0 vs.8/11,x2 =5.091) in intervention group than those in control group (P < 0.05).And both the readmission rate for home care patients [2.4% (1/41) vs.36.8% (14/38),x2 =15.175] and for patients with complications [1/12 vs.43.8% (14/38),x2 =4.872] was much lower in intervention group than that in control group (both P < 0.05).Conclusion The family doctor team care can reduce the risk of complications and readmission to hospital,and also can improve the quality of life of home care disabled elderly,as well as reduce the burden of family and society.
出处
《中华全科医师杂志》
2016年第7期524-528,共5页
Chinese Journal of General Practitioners
关键词
医师
家庭
居家养老
失能老人
Physicians, family
Home care
Disabled elderly