Disability is more prevalent among the elderly. However, evidence on the factors associated with disability among them is limited. Therefore, this paper addresses the spatial and socio-demographic correlates of disability among individuals aged 60 and over in Indonesia. We employ data from the 2013 Indonesian National Socioeconomic Survey (SUSENAS). We defined disability as having any difficulties in doing daily activities using the ‘Low Threshold’ assumption. We fitted a multivariable logistic regression model to the dataset and evaluated statistical significance at the 95% level. The final regression model is statistically significant (P<0.001) with a sample of 23,709 individuals. The results show that 45.35% of the elderly reported being disabled. Moreover, higher age is associated with higher odds of being disabled (OR = 1.16; 95%; 95% CI = 1.10-1.23). An elderly living without a spouse is more likely to be disabled (OR = 1.54; 95% CI = 1.43-1.64). We also observed provincial differences in disabilities. Furthermore, elderly living in rural areas have higher odds of being disabled (OR = 1.18; 95% CI = 1.12-1.25) compared to their urban counterparts. Our results imply that the Indonesian elderly with certain characteristics are more vulnerable than others which requires long term care.
残疾在老年人中更为普遍。然而，关于其中与残疾有关的因素的证据有限。因此，本文讨论了印度尼西亚60岁及以上人群残疾的空间和社会人口相关关系。我们采用了2013年印尼国家社会经济调查(SUSENAS)的数据。我们使用“低阈值”假设将残疾定义为在日常活动中有任何困难。我们对数据集拟合了多变量logistic回归模型，并在95%水平上评估了统计显著性。最终的回归模型在23,709个人的样本中具有统计学意义(P<0.001)。结果显示，45.35%的老年人报告残疾。此外，年龄越大，残疾的几率越大(OR = 1.16;95%;95% ci = 1.10-1.23)。无配偶生活的老年人更容易残疾(OR = 1.54;95% ci = 1.43-1.64)。我们还观察到各省在残疾方面的差异。此外，生活在农村地区的老年人残疾的几率更高(OR = 1.18;95% CI = 1.12-1.25)。我们的研究结果表明，具有某些特征的印度尼西亚老年人比其他需要长期护理的老年人更脆弱。
{"title":"Disability among the Elderly in Indonesia: An Analysis of Spatial and Socio-demographic Correlates","authors":"Puguh Prasetyoputra, A. Prasojo","doi":"10.3390/IECGCM-1-06167","DOIUrl":"https://doi.org/10.3390/IECGCM-1-06167","url":null,"abstract":"Disability is more prevalent among the elderly. However, evidence on the factors associated with disability among them is limited. Therefore, this paper addresses the spatial and socio-demographic correlates of disability among individuals aged 60 and over in Indonesia. We employ data from the 2013 Indonesian National Socioeconomic Survey (SUSENAS). We defined disability as having any difficulties in doing daily activities using the ‘Low Threshold’ assumption. We fitted a multivariable logistic regression model to the dataset and evaluated statistical significance at the 95% level. The final regression model is statistically significant (P<0.001) with a sample of 23,709 individuals. The results show that 45.35% of the elderly reported being disabled. Moreover, higher age is associated with higher odds of being disabled (OR = 1.16; 95%; 95% CI = 1.10-1.23). An elderly living without a spouse is more likely to be disabled (OR = 1.54; 95% CI = 1.43-1.64). We also observed provincial differences in disabilities. Furthermore, elderly living in rural areas have higher odds of being disabled (OR = 1.18; 95% CI = 1.12-1.25) compared to their urban counterparts. Our results imply that the Indonesian elderly with certain characteristics are more vulnerable than others which requires long term care.","PeriodicalId":301449,"journal":{"name":"Proceedings of 1st International Electronic Conference on Geriatric Care Models","volume":"08 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127255453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pressure injuries are areas of localised damage to skin and underlying tissue, usually over bony prominences. They are associated with pain, prolonged hospitalisation, poor quality of life, increased morbidity and risk of mortality. An audit of pressure injury risk assessment forms on medical wards identified poor compliance with pressure injury prevention and increased prevalence of pressure injuries among patients, from 1.6% in 2011 to 20.4% in 2015. A study exploring nurses knowledge and practices on wound assessment identified more than half of the participants had limited knowledge, confirmed in an audit of nursing documentation of wound progress. Interventions to reduce risk of pressure injuries and improve management of pressure injuries require a comprehensive and multidisciplinary approach. The framework used to achieve this are outlined. Multicomponent interventions involving development of care practices using a team approach include standardising pressure injury documentation and continuous education. The TaPIE (TAilored Pressure Injury Education) intervention for nurses and caregivers on reducing pressure injury is currently being undertaken. Nurse-led wound management utilising the TIME approach and monthly wound case conference improved ward-based management of pressure injuries. Community follow-up by home based nurses of complex wounds is facilitated by tele-assessment through electronic digital images shared with clinicians if there are uncertainties in management.
{"title":"Multicomponent interventions to prevent and manage pressure injuries in hospital","authors":"Hjh Noridah Hj Abdul Halim, S. Teo","doi":"10.3390/IECGCM-1-06169","DOIUrl":"https://doi.org/10.3390/IECGCM-1-06169","url":null,"abstract":"Pressure injuries are areas of localised damage to skin and underlying tissue, usually over bony prominences. They are associated with pain, prolonged hospitalisation, poor quality of life, increased morbidity and risk of mortality. \u0000An audit of pressure injury risk assessment forms on medical wards identified poor compliance with pressure injury prevention and increased prevalence of pressure injuries among patients, from 1.6% in 2011 to 20.4% in 2015. A study exploring nurses knowledge and practices on wound assessment identified more than half of the participants had limited knowledge, confirmed in an audit of nursing documentation of wound progress. Interventions to reduce risk of pressure injuries and improve management of pressure injuries require a comprehensive and multidisciplinary approach. The framework used to achieve this are outlined. \u0000Multicomponent interventions involving development of care practices using a team approach include standardising pressure injury documentation and continuous education. The TaPIE (TAilored Pressure Injury Education) intervention for nurses and caregivers on reducing pressure injury is currently being undertaken. Nurse-led wound management utilising the TIME approach and monthly wound case conference improved ward-based management of pressure injuries. Community follow-up by home based nurses of complex wounds is facilitated by tele-assessment through electronic digital images shared with clinicians if there are uncertainties in management.","PeriodicalId":301449,"journal":{"name":"Proceedings of 1st International Electronic Conference on Geriatric Care Models","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115173688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Thomas, R. Rao, Cathy C. Schubert, A. Nagel, R. Kafer
Background: Heart failure is the number one cause of hospital readmissions among Veteran Affairs (VA) patients. We implemented a home-based RN/LPN team who provided short-term, intensive CHF case management in collaboration with a cardiologist with the goal of reducing 30-day readmissions, ER visits, and hospitalizations. Methods: This retrospective study evaluated ER visits, admissions, 30-day readmission rates, and total inpatient days for 108 CHF patients at the Indianapolis VA Medical Center enrolled in the home-based CHF program from May 2016-September 2017. Data was retrieved from national VA databases as well as the electronic medical record. We compared patients’ acute care utilization six months prior to the program, during the program, and at six months post-program discharge using chi squared test. Results: 500 Veterans were admitted with HF at our hospital in 2016 with the 30-day readmission rate of 21% before our program start date. When comparing all 500 HF patients admitted at our VA with the 108 patients enrolled, the difference in 30-day readmissions was significant (p <.001), with only 7% of our patients having a 30-day readmission within the first 30 days of enrollment into the program. When comparing our study population itself six months pre-program versus during program, there was a large reduction in ER visits and admissions per patient during the program (0.537 vs. 0.361) and (1.63 vs. 0.296). When comparing 6 months pre-program vs. during program enrollment and 6 months post-program discharge, the number of total inpatient days per person was drastically reduced (9.31 vs. 1.33) (9.31 vs 2.73). Using the average cost of one day in the hospital, $3,400, the VA saved approximately $22,372 per patient during our study. The average cost for the CHF home care team yearly is $213, 004, whereas the approximate savings for this program per year is $4,832,352, giving a total annual cost savings of $4,619,348. Conclusions: Short-term, intensive home-based teams for high-risk Veterans with CHF can reduce ER visits, admissions, 30-day readmissions, and the number of inpatient days and be highly cost-effective. This home-based care model must also be noted for showing significant effect persisting after the formal program/intervention ended as there was a continued sizable reduction 6 months post-program discharge in total inpatient days.
背景:心力衰竭是退伍军人事务(VA)患者再入院的头号原因。我们实施了一个以家庭为基础的RN/LPN团队，他们与心脏病专家合作，提供短期、强化的CHF病例管理，目标是减少30天的再入院、急诊室就诊和住院。方法:本回顾性研究评估了2016年5月至2017年9月在印第安纳波利斯VA医疗中心参加以家庭为基础的CHF项目的108例CHF患者的急诊就诊、入院情况、30天再入院率和总住院天数。数据是从国家退伍军人管理局数据库以及电子病历中检索的。我们使用卡方检验比较了患者在项目前6个月、项目期间和项目后6个月的急性护理利用情况。结果:2016年我院收治了500例HF退伍军人，在项目开始前30天再入院率为21%。当比较我们VA收治的所有500例HF患者与入组的108例患者时，30天再入院的差异是显著的(p < 0.001)，只有7%的患者在入组的前30天内再入院30天。当比较我们的研究人群本身在项目前6个月与项目中6个月时，每个患者在项目期间的急诊就诊和住院次数大幅减少(0.537 vs 0.361)和(1.63 vs 0.296)。当比较项目前6个月与项目注册期间和项目后6个月出院时，每人总住院天数大幅减少(9.31 vs 1.33) (9.31 vs 2.73)。在我们的研究中，以住院一天的平均费用3400美元计算，退伍军人事务部为每位患者节省了大约22372美元。瑞士法郎家庭护理团队每年的平均成本为213,004美元，而这个项目每年大约节省4,832,352美元，每年节省的总成本为4,619,348美元。结论:针对高风险退伍军人CHF的短期强化家庭团队可以减少急诊室就诊次数、入院次数、30天再入院次数和住院天数，具有很高的成本效益。这种以家庭为基础的护理模式在正式项目/干预结束后仍显示出显著的效果，因为项目后6个月出院总住院天数持续大幅减少。
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