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首页> 外文期刊>Journal of the American Geriatrics Society >Comparison of functional outcomes associated with hospital at home care and traditional acute hospital care.
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Comparison of functional outcomes associated with hospital at home care and traditional acute hospital care.

机译：与在家中医院护理和传统急性医院护理相关的功能结局比较。

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OBJECTIVES: To compare differences in the functional outcomes experienced by patients cared for in Hospital at Home (HaH) and traditional acute hospital care. DESIGN: Survey questionnaire of participants in a prospective nonrandomized clinical trial. SETTING: Three Medicare managed care health systems and a Veterans Affairs Medical Center. PARTICIPANTS: Two hundred fourteen community-dwelling elderly patients who required acute hospital admission for community-acquired pneumonia, exacerbations of chronic heart failure or chronic obstructive pulmonary disease, or cellulitis, 84 of whom were treated in HaH and 130 in an acute care hospital. INTERVENTION: Treatment in a HaH care model that substitutes for care provided in the traditional acute care hospital. MEASUREMENTS: Change in activity of daily living (ADL) and instrumental activity of daily living (IADL) scores from 1 month before admission to 2 weeks post admission to HaH or acute hospital and the proportion of groups that experienced improvement, no change, or decline in ADL and IADL scores. RESULTS: Patients treated in HaH experienced modest improvements in performance scores, whereas those treated in the acute care hospital declined (ADL, 0.39 vs -0.60, P=.10, range -12.0 to 7.0; IADL 0.74 vs -0.70, P=.007, range -5.0 to 10.0); a greater proportion of HaH patients improved in function and smaller proportions declined or had no change in ADLs (44% vs 25%, P=.10) or IADLs (46% vs 17%, P=.04). CONCLUSION: HaH care is associated with modestly better improvements in IADL status and trends toward more improvement in ADL status than traditional acute hospital care.
机译：目的：比较在家中医院（HaH）和传统的急性医院护理患者的功能结局的差异。设计：对一项前瞻性非随机临床试验参与者的问卷进行调查。地点：三个由Medicare管理的护理健康系统和一个退伍军人事务医疗中心。参与者：241名社区居民老年患者，这些患者因社区获得性肺炎需要急性入院，慢性心力衰竭或慢性阻塞性肺疾病或蜂窝织炎的恶化，其中84例在HaH接受治疗，130例在急诊医院接受治疗。干预：在HaH护理模型中进行的治疗可替代传统急诊医院提供的护理。测量：从入院前1个月到入院或急诊后2周，每天的日常生活活动（ADL）和日常生活的器械活动评分（IADL）的变化，以及经历了改善，无变化或下降的人群比例在ADL和IADL分数中。结果：在HaH中接受治疗的患者的表现得分有所改善，而在急诊医院接受治疗的患者则有所下降（ADL，0.39 vs -0.60，P = .10，范围-12.0至7.0; IADL 0.74 vs -0.70，P =。 007，范围-5.0至10.0）;大部分HaH患者的功能得到改善，而较小比例的ADL（44％比25％，P = .10）或IADL（46％比17％，P = .04）下降或没有变化。结论：与传统的急性医院护理相比，HaH护理与IADL状况适度更好的改善以及ADL状况的改善趋势有关。

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