痴呆症专业护理团队对一家综合医院临床疗效的影响。

IF 3.8 4区 医学 Q1 PSYCHIATRY Asian journal of psychiatry Pub Date : 2024-09-27 DOI:10.1016/j.ajp.2024.104256
Yutaro Shimomura , Waka Nishimura , Masayuki Murayama , Kimio Yoshimura , Masaru Mimura , Hiroyuki Uchida , Hiroyoshi Takeuchi , Kazuhiro Shishida
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引用次数: 0

摘要

背景:由于痴呆症在日本的发病率越来越高,政府于 2016 年在急诊医院引入了痴呆症专科护理的经济激励措施。我们医院随后引入了一个多学科协作的专业团队,简称为痴呆症专业护理团队。本研究旨在探讨失智症专科护理团队对老年住院患者临床疗效的影响:在日本一家拥有 650 张病床的综合医院开展的这项回顾性观察研究中,我们比较了干预前两年(2014-2015 年)和干预后两年(2017-2018 年)期间 65 岁及以上住院患者的跌倒发生率、催眠药处方、住院时间、院内死亡率和出院去向等临床结果:在观察期内,共有34097名患者入院,其中干预前有16237名患者,干预后有17860名患者。接受任何催眠药的患者比例从 21.2% 降至 19.2%,尤其是苯二氮卓类药物的比例从 19.8% 降至 13.2%。从坐姿或卧姿跌倒的发生率,尤其是夜间跌倒的发生率明显降低(从 0.5% 降至 0.2%),干预后的住院时间也明显缩短(从 13.7 天缩短至 13.2 天):结论:在实施痴呆症专业护理团队后,观察到了良好的效果,如减少了催眠药的使用、跌倒发生率和住院时间。该团队的引入及相关激励措施可有效改善老年住院患者的临床疗效。
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Influence of dementia-specialized care team on clinical outcomes in a general hospital

Background

Because of the increasing prevalence of dementia in Japan, the government introduced financial incentives for specialized care for dementia at acute care hospitals in 2016. Our hospital then introduced a multidisciplinary collaborative specialized team, referred to as dementia-specialized care team. The aim of this study is to examine the influence of dementia-specialized care team on clinical outcomes for elderly inpatients.

Methods

In this retrospective observational study at a general hospital with 650 beds in Japan, we compared clinical outcomes such as incidence of falls, prescription of hypnotics, length of hospital stay, in-hospital mortality, and discharge destinations in inpatients aged 65 years and older between a two-year pre-intervention period (2014–2015) and a two-year post-intervention period (2017–2018).

Results

During the observation period, a total of 34,097 patients were admitted, with 16,237 patients in the pre-intervention period and 17,860 patients in the post-intervention period. The proportion of patients receiving any hypnotics decreased from 21.2 % to 19.2 %, notably with benzodiazepine from 19.8 % to 13.2 %. The incidence of falls from a seated or lying position, particularly at night, was significantly lower (from 0.5 % to 0.2 %) as was the length of hospital stay (from 13.7 days to 13.2 days) during the post-intervention period.

Conclusion

After the implementation of dementia-specialized care team, favorable outcomes such as a reduction in the use of hypnotics, the incidence of falls, and the length of hospitalization were observed. Introduction of the team and associated incentives may be effective in improving clinical outcomes in elderly inpatients.
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来源期刊
Asian journal of psychiatry
Asian journal of psychiatry Medicine-Psychiatry and Mental Health
CiteScore
12.70
自引率
5.30%
发文量
297
审稿时长
35 days
期刊介绍: The Asian Journal of Psychiatry serves as a comprehensive resource for psychiatrists, mental health clinicians, neurologists, physicians, mental health students, and policymakers. Its goal is to facilitate the exchange of research findings and clinical practices between Asia and the global community. The journal focuses on psychiatric research relevant to Asia, covering preclinical, clinical, service system, and policy development topics. It also highlights the socio-cultural diversity of the region in relation to mental health.
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