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首页> 外文期刊>The journals of gerontology.Series A. Biological sciences and medical sciences >Hospitalizations at the end of life among long-term care residents.
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Hospitalizations at the end of life among long-term care residents.

机译：长期护理居民生命终期住院。

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BACKGROUND: Concerns have been raised over transfers into acute care hospitals at the end of life. The objective of this study was to examine (a) the extent of and (b) factors related to hospitalization in the last 180 days before death among long-term care (LTC) residents. METHODS: The study included all LTC residents from 60 facilities in the province of Manitoba, Canada, who died in 2003/04 (N = 2,379), with data derived from administrative health care records. Multilevel regression analyses were conducted to examine the relationship between resident and facility characteristics and the following: location of death (in hospital vs the LTC facility); whether individuals were hospitalized in the last 180 days before death; and number of hospital days in the last 180 days. RESULTS: Overall, 19.1% of LTC residents died in hospital; however, 40.7% were hospitalized at least once in the last 6 months before death. Several resident characteristics (age, trajectory group, and level of care) were related to the outcome measures. Living in a not-for-profit LTC facility decreased the odds of dying in hospital (adjusted odds ratio [OR] = 0.589; 95% confidence interval [CI] = 0.402-0.863) or being hospitalized (adjusted OR = 0.647; 95% CI = 0.452-0.926). CONCLUSIONS: Hospitalization at the end of life is common among LTC residents, and the likelihood of hospital transfers is increased for residents who are younger, have organ failure, lower care level needs, as well as among those who live in for-profit facilities. Particular emphasis should, therefore, be placed on targeting these groups to determine the appropriateness of hospital admission and possible ways of reducing transfers.
机译：背景：生命周期结束后，人们对转移到急诊医院的问题提出了担忧。这项研究的目的是检查长期护理（LTC）居民中（a）死亡前最近180天的住院程度和（b）与住院有关的因素。方法：该研究包括来自加拿大曼尼托巴省60家医疗机构的LTC居民，这些居民于2003/04年去世（N = 2379），其数据来自行政医疗记录。进行了多级回归分析，以检查居民和设施特征与以下各项之间的关系：死亡地点（医院与LTC设施）;个人在死亡前的最后180天是否住院;和最近180天的住院天数。结果：总体而言，有19.1％的LTC居民在医院死亡。但是，有40.7％的人在死亡前的最后六个月中至少住院过一次。几个住院病人的特征（年龄，轨迹组和护理水平）与结果指标有关。在非营利性LTC机构中生活或住院的可能性降低了（调整后的优势比[OR] = 0.589; 95％的置信区间[CI] = 0.402-0.863）或住院（调整后的OR = 0.647; 95％） CI = 0.452-0.926）。结论：LTC居民在临终时住院是很普遍的，对于年轻，患有器官衰竭，需要较低医疗水平的居民以及居住在营利性设施中的居民，住院治疗的可能性增加。因此，应特别针对这些人群，以确定入院的适当性以及减少转诊的可能方法。

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