上海市某三甲医院老年慢性病患者出院安置现状调查及影响因素分析  

Investigation and Influencing Factors Analysis of the Current Situation of Discharge Disposition of Elderly Patients with Chronic Diseases in a Tertiary Hospital in Shanghai

作　　者：宫克[1] 邵志民[1] 陈清如 张雪峰[1] 白姣姣[1] GONG Ke;SHAO Zhi-min;CHEN Qing-ru(Huadong Hospital Affiliated to Fudan University,Shanghai,200040,Chin)

机构地区：[1]复旦大学附属华东医院,上海200040

出　　处：《中国医院管理》2020年第10期49-53,67,共6页Chinese Hospital Management

摘　　要：目的探索老年慢性病患者出院安置的影响因素,为有需要的患者精准对接安置机构,提升过渡期服务的有效性。方法对2020年3—5月间上海市某三甲医院403名老年慢性病住院患者进行问卷调查。结果出院时选择非居家安置的老年慢性病患者占11.4%。logistic回归分析表明,患者日常生活活动能力、入院诊断、有无子女及是否独居是影响出院安置选择的重要因素,其差异有统计学意义(P<0.05)。患者及家属选择出院安置的考虑因素中,社会资源知晓度、照顾专业度、机构地理位置对于出院安置选择差异有统计学意义(P<0.05)。结论出院安置选择是病患个体及其家庭与所处环境互动的体现,需要综合考虑疾病与功能状况、家庭和社会资源、居住环境、经济状况、社会政策等因素,可从政府、医院、个人3方面入手,促进医、康、养、护资源协同,协助患者及家属做好出院安置选择。Objective To explore the influencing factors that affect discharge disposition of elderly patients with chronic diseases,aiming to accurately connect facilities for patients in need and improve the effectiveness of transitional care.Methods A questionnaire was used to investigate the status of discharge disposition of 403 elderly patients with chronic diseases in a tertiary hospital in Shanghai from March to May,2020.Results 11.4%of the patients with chronic diseases were discharged to nursing home,rehabilitation units or other facilities instead of returning home.Logistic regression analysis showed that Activities of Daily Living,diagnosis,having children,and living alone were significantly associated with the discharge disposition(P<0.05).The considerations of the decision making of the discharge disposition,including the awareness of social resources,the professional degree of care and geographic location of the facilities were significantly associated with discharge disposition(P<0.05).Conclusion The influencing factors that affect the discharge disposition of elderly patients with chronic diseases are complicated.It is necessary to assist patients and their families to choose an appropriate discharge disposition at the levels of individuals,hospitals,and government,and promote the coordination of the medicine,rehabilitation and care.

关 键 词：出院安置 老年 慢性病 影响因素 

分 类 号：R197.323.2[医药卫生—卫生事业管理]