CAJ | 학술논문

目的：高龄老人的多病、衰弱、失能等问题使其在住院治疗时更易发生转诊相关问题，即各种造成出院后脆弱性增加的情况。因而有必要了解该人群住院的相关情况，以改进转诊质量。方法2012年6月至2012年12月期间对北京市城区部分＞85岁的社区老人及其照料者进行入户调查，了解其近期的住院情况。结果共调查395名社区居住的高龄老人。1年之内有住院经历的有86例[年龄（94.8±6.5）岁，中位年龄96岁]，其中生活不能自理者占31.4%。住院原因主要为感染（34.6%）、心脏疾病（16.0%）、消化系统疾病（11.1%）及意外伤害（9.9%）；住院过程中发生的老年问题分别为跌倒（4.9%）、情绪问题（19.8%）、体力下降（31.3%）；出院时涉及的转诊问题主要为无出院宣教（25.9%）、不清楚住院治疗情况（36.5%）、不知出院后如何用药（25.9%）、不知出院后注意事项（30.6%）。结论高龄老年患者住院易出现多种转诊问题，应在患者住院及出院时予以预防及干预，以提高医疗质量。
목적：고령노인적다병、쇠약、실능등문제사기재주원치료시경역발생전진상관문제，즉각충조성출원후취약성증가적정황。인이유필요료해해인군주원적상관정황，이개진전진질량。방법2012년6월지2012년12월기간대북경시성구부분＞85세적사구노인급기조료자진행입호조사，료해기근기적주원정황。결과공조사395명사구거주적고령노인。1년지내유주원경력적유86례[년령（94.8±6.5）세，중위년령96세]，기중생활불능자리자점31.4%。주원원인주요위감염（34.6%）、심장질병（16.0%）、소화계통질병（11.1%）급의외상해（9.9%）；주원과정중발생적노년문제분별위질도（4.9%）、정서문제（19.8%）、체력하강（31.3%）；출원시섭급적전진문제주요위무출원선교（25.9%）、불청초주원치료정황（36.5%）、불지출원후여하용약（25.9%）、불지출원후주의사항（30.6%）。결론고령노년환자주원역출현다충전진문제，응재환자주원급출원시여이예방급간예，이제고의료질량。
Objective Because of the multimorbidity, frailty and disability among the elder seniors, they are prone to suffering from transition problems, which can cause an additional vulnerability after discharge from hospitals. It is necessary to investigate such problems to improve the quality of referral. Methods Household survey was performed in community-dwelling residents over 85 years in some urban districts of Beijing from June to December 2012 in order to know their situation in recent hospitalization. Results There were 395 elder seniors living in communities surveyed in this study. Eighty-six (21.8%) of them had the experiences of hospital admission in the past 1 year with an age of (94.8±6.5) years and median age of 96 years. The admitted seniors living dependently accounted for 31.4%. The main reasons for admission included infections (34.6%), heart diseases (16.0%), gastrointestinal disorders (11.1%) and accidental injuries (9.9%). The geriatric problems during hospital stay were fallings (4.9%), emotional problems (19.8%), and loss of physical activities (31.3%). The referral problems at discharge were no discharge education by healthcare workers (25.9%), the elder patients not knowing what happened during admission (36.5%), nor how to take the drugs (25.9%) or not knowing the issues which deserve attention after discharge (30.6%). Conclusion The elder seniors are prone to suffering from the referral problems. The healthcare workers should implement prevention and intervention for such problems during hospitalization and at discharge so as to improve the medical quality.