住院病患老年專科服務的初步經驗分析－以耕莘醫院老人周全性評估爲例

The In-patient Geriatric Interdisciplinary Care-a Preliminary Experience in Cardinal Tien Hospital

劉樹泉(Shu-Chuen Lau) ； 江維鏞(Wai-Yung Chiang) ； 劉惠賢(Wai-Yin Lau) ； 林怡君(I-Chun Lee) ； 陳鑑江(Kam-Kong Chan)

《台灣老年醫學暨老年學雜誌》 3卷3期 (2008/08) Pp. 193-201

https://doi.org/10.29461/TGG.200808.0003

摘要

Introduction: While fairly well established in other countries, the effectiveness of inpatient comprehensive geriatric assessment remains in need of evaluation and verification in Taiwan. Methods: Data regarding to the care of high-risk geriatric inpatients were collected from February 2002 to December 2006 in Cardinal Tien Hospital. The inpatients in the orthopedic ward were included in the analysis since they also received the consultation service from the hospital's geriatric team. Results: 693 elderly patients (average age=81.3+7.1, male 41.7%) received comprehensive geriatric assessment. Members of the interdisciplinary geriatric team completed their assessment in their specialty fields within 48 hours of admission whatever. The average length of stay in hospital was 9.5+6.2 days, and the length of stay increased with the number of health & care problems troubling a patient (p＜0.0001). Upon discharge, significant improvement was observed in the activity of daily living (ADL) (p＜0.0001) but not in other functions. The improvement in ADL appeared to be more obvious in patients at the orthopedic department than in those at the internal medicine department (p＜0.0001). In regards to 52 elderly patients expired during follow-up (45 in the internal medicine and 7 in orthopedics, totally 8% of all elderly in the study). Each elder care receiver were supposed to share NT$18,401 of cost on the geriatric assessment service potentially. But rather, comprehensive assessment for the elderly should consume more significant resource. Conclusion: The comprehensive geriatric assessment is not only a diagnostic tool but also a process of care. It can be applied to and is useful for every medical specialty. The average length of stay was shorter and the improvement in ADL more significant for those patients receiving comprehensive geriatric care. The improvement in ADL was more obvious in orthopedic inpatients than in their internal medicine counterparts.

關鍵字

周全性功能評估 ； 住院病人 ； 老人

並列摘要

Introduction: While fairly well established in other countries, the effectiveness of inpatient comprehensive geriatric assessment remains in need of evaluation and verification in Taiwan. Methods: Data regarding to the care of high-risk geriatric inpatients were collected from February 2002 to December 2006 in Cardinal Tien Hospital. The inpatients in the orthopedic ward were included in the analysis since they also received the consultation service from the hospital's geriatric team. Results: 693 elderly patients (average age=81.3+7.1, male 41.7%) received comprehensive geriatric assessment. Members of the interdisciplinary geriatric team completed their assessment in their specialty fields within 48 hours of admission whatever. The average length of stay in hospital was 9.5+6.2 days, and the length of stay increased with the number of health & care problems troubling a patient (p＜0.0001). Upon discharge, significant improvement was observed in the activity of daily living (ADL) (p＜0.0001) but not in other functions. The improvement in ADL appeared to be more obvious in patients at the orthopedic department than in those at the internal medicine department (p＜0.0001). In regards to 52 elderly patients expired during follow-up (45 in the internal medicine and 7 in orthopedics, totally 8% of all elderly in the study). Each elder care receiver were supposed to share NT$18,401 of cost on the geriatric assessment service potentially. But rather, comprehensive assessment for the elderly should consume more significant resource. Conclusion: The comprehensive geriatric assessment is not only a diagnostic tool but also a process of care. It can be applied to and is useful for every medical specialty. The average length of stay was shorter and the improvement in ADL more significant for those patients receiving comprehensive geriatric care. The improvement in ADL was more obvious in orthopedic inpatients than in their internal medicine counterparts.

並列關鍵字

comprehensive geriatric assessment ； in-patients ； elderly