住院服务中患者功能独立性和职业治疗师时间使用:患者人口统计学和临床相关性。

Bianca E Summers, Kate E Laver, Rebecca J Nicks, Nadine E Andrew, Christopher J Barr, Laura Jolliffe, Natasha A Lannin
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摘要

澳大利亚的医疗保健支出迅速增加。必须有效管理职业治疗服务,以满足临床需求。提高我们对影响职业治疗服务提供的因素的理解是管理工作量分配和优化服务效率的重要一步。本研究旨在探讨18岁以上住院病人的社会人口学特征、诊断和功能独立性对职业治疗资源利用的影响。方法:前瞻性、横断面、观察性队列研究,来自澳大利亚墨尔本三家医院的4549名住院患者。从组织数据库中提取并纳入本研究的数据包括:患者人口统计、诊断、使用功能自主测量系统(SMAF)评估的功能水平和职业治疗时间使用。数据分析采用单变量和多变量模型。结果:职业治疗时间使用与分析中包含的所有变量显著相关(p)。结论:繁忙医院的资源管理需要了解与职业治疗师时间使用相关的因素。该研究发现,时间利用可以通过功能独立性、诊断和社会人口学特征来部分预测。职业治疗管理人员可以利用这些信息来支持决策,同时承认其他患者和治疗师层面的因素也会影响时间的使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Patient functional independence and occupational therapist time-use in inpatient services: Patient demographic and clinical correlates.

Introduction: Health care expenditure has rapidly increased in Australia. Effective management of occupational therapy services is required to meet clinical demand. Improving our understanding of factors which influence occupational therapy service delivery is a vital step to manage workload distribution and optimise service efficiency. This study aims to examine the influence of patient sociodemographic characteristics, diagnosis and functional independence on the utilisation of occupational therapy resources in hospital inpatients over 18 years old.

Methods: Prospective, cross-sectional, observational cohort study of 4549 inpatients from three hospital sites in Melbourne, Australia. Data extracted from organisational databases and included in this study were: patient demographics, diagnosis, functional level assessed using the SMAF (Functional Autonomy Measurement System) and occupational therapy time-use. Data were analysed using univariable and multivariable modelling.

Results: Occupational therapy time-use was significantly associated with all variables included in analysis (p < 0.05). For each variable the amount and direction of effect differed between hospital sites. The SMAF was the only variable consistently associated with occupational therapy time-use. Higher occupational therapy time-use was associated with lower functional independence (leading to a 3.5 min increase in median occupational therapy time for every unit decrease in SMAF score).

Conclusions: Management of resources within busy hospitals require knowledge of factors associated with occupational therapist time-use. This study identified that time-use could in part be predicted by functional independence, diagnosis and sociodemographic characteristics. Occupational therapy managers can use this information to support decision making while acknowledging other patient and therapist level factors also influence time-use.

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