摘要
目的:探索老年“慢重症”诊疗体系建设的现状及存在的问题,为相关政策的制定提供循证依据。方法:采用探索性研究方法,对安徽省16家公立医疗机构及其227名老年“慢重症”患者进行问卷调查,描述性统计分析用于展示变量的特征和分布情况。结果:本调查老年“慢重症”患者平均年龄80.76±9.67岁;平均患病种数为4.31±1.02个;老年危重病人占比17.18%;患者第一诊断疾病不可逆占比72.25%;患者监护人对于患者持积极治疗态度占比62.56%;在被调查的医疗机构中,老年重症监护病房常用设备拥有率和必要技术开展率视设备和技术的不同而不等;患者参保类型最多的为城镇职工医保,占比53.3%;患者来源最多的是来自家庭,占比65.2%;患者监护人单次诊疗经济承受能力在1万元以下的占比为48.90%。结论:老年“慢重症”是严重影响老年人生命质量的重要疾患,患病比例高,资源需求多,社会影响大,医疗机构相关设备和技术力量不足。今后仍需在体制、机制、诊疗规范、人才引进与培养、科研等方面促进老年“慢重症”诊疗体系建设。开展老年“慢重症”探索性研究,对提高老年“慢重症”患者的就诊体验,减轻就医负担,制定和完善相关政策具有积极意义。
Objective To explore the current situation and problems in the construction of the diagnosis and treatment system for chronic critical illness of old adults,and provide an evidence-based basis for the formulation of relevant policies.Methods An exploratory research method was used to conduct a questionnaire survey on 16 public medical institutions and 227 elderly patients with chronic critical llness in Anhui Province.Descriptive statistical analysis was used to analyze the characteristics and distribution of variables.Results The average age of the elderly patients with chronic illness was 80.76±9.67 years old.The average number of illnesses was 4.31±1.02.The proportion of elderly critically ill patients was 17.18%.The proportion of patients with irreversible disease in the first diagnosis was 72.25%.And the proportion of patients with guardians positive attitude towards the treatment was 62.56%.For the surveyed medical institutions,the ownership rate of commonly used equipment and the implementation rate of necessary technology in the geriatric intensive care wards varied depending on the equipment and technology.The largest number of patients enrolled in the type of insurance was the urban workers'medical insurance(53.30%).The largest number of patients came from their families(65.20%).And the financial capacity of the patients guardians for a single consultation was less than 10,000 Yuan(48.90%).Conclusion Chronic critical illness is an important disease that seriously affects the quality of life of the old adults,with a high prevalence rate,high demand for resources,great social impact,and insufficient equipment and technical force in medical institutions.In the future,it is still needed to promote the construction of a diagnosis and treatment system for the chronic critical illness of older adults in terms of institutions,mechanisms,diagnosis and treatment standards,introduction and cultivation of talents,and scientific research.It is of positive significance to conduct an exploratory study on chronic critical illness in the elderly to improve the experience of elderly patients with chronic critical illness,reduce their burden of medical care,and formulate and improve relevant policies.
作者
倪刚
白忠良
李亚南
王羊洋
倪琛琛
金吴娟
陈任
郑海洋
姚登攀
胡志
Ni Gang(The Third Affiliated Hospital of Anhui Medical University,Hefei First People's Hospital,Hefei,P.R.China)
出处
《中国卫生事业管理》
北大核心
2025年第9期1076-1080,共5页
Chinese Health Service Management
基金
国家自然科学基金“基于社会资本理论的健康老龄化研究”(71573002)
公共健康社会治理安徽省哲学社会科学重点实验室项目“医防融合背景下基层医疗卫生机构慢病防控能力提升机制研究”(PHG202401)
安徽省高校健康智库资政项目“人口老龄化背景下老年慢重症患者诊疗策略研究”(2023szk001)。
关键词
人口老龄化
老年慢重症
诊疗体系
探索性研究
population aging
chronic critical illness of old adults
diagnosis and treatment system
exploratory research
