Cristin-prosjekt-ID: 539198
Registrert av: REK Sist endret: 13. desember 2019 15:00

Cristin-prosjekt-ID: 539198
Registrert av: REK Sist endret: 13. desember 2019 15:00
Prosjekt

Evaluering av kommunalt øyeblikkelig hjelp-døgntilbud

prosjektleder

Sabine Ruths
ved NORCE Helse - Allmennmedisin ved NORCE Norwegian Research Centre AS

prosjekteier / koordinerende forskningsansvarlig enhet

  • NORCE Helse - Allmennmedisin ved NORCE Norwegian Research Centre AS

Godkjenninger

  • Regionale komitéer for medisinsk og helsefaglig forskningsetikk (REK) - 2017/630

Klassifisering

Vitenskapsdisipliner

Allmennmedisin

Emneord

Allmennmedisin • Helsetjeneste

HRCS-helsekategori

  • Andre

HRCS-forskningsaktivitet

  • 8.1 Organisering og levering av tjenester

Kategorier

Prosjektkategori

  • Anvendt forskning

Helseprosjekttype

Annet studium

Tidsramme

Avsluttet
Start: 1. juni 2017 Slutt: 31. desember 2019

Beskrivelse Beskrivelse

Tittel

Evaluering av kommunalt øyeblikkelig hjelp-døgntilbud

Populærvitenskapelig sammendrag

Vi har for lite kunnskap om kommunalt øyeblikkelig hjelp døgn (ØHD) enheter tilbyr behandling til de rette pasientene og om tilbudet reduserer antall innleggelser på sykehus. I denne studien vi evaluere ØHD tilbudet i en kommune og undersøke pasienter og aktiviteter gjennom de første 4 års drift. Metode: for alle pasienter innlagt i perioden 1.6.2012-31.12.2016 blir journalopplysninger innhentet: demografiske data, innleggende instans, omsorgsnivå på innleggelsestidspunktet, tentativ hoveddiagnose ved innleggelse, MEWS-score (modified early warning score), ADL (activities of daily living) ved innleggelse, under opphold og ved utskrivning, diagnostiske undersøkelser og behandling under oppholdet, antall dager i ØHD-seng og reinnleggelser, diagnostikk utført utenfor ØHD (f.eks. røntgen). Statistisk analyse: Data vil bli presentert som gjennomsnitt og prosenter med 95% konfidensintervall og analysert med lineær regresjon og chi-kvadrat tester i statistikkprogrammet SPSS.

Vitenskapelig sammendrag

OBJECTIVE:

To evaluate the use of a small municipality acute bed unit (MAU) in rural Norway resulting from the Coordination reform regarding occupancy-rate, patient characteristics and healthcare provided during the first four years of operation. Further, to investigate whether implementation of the new municipal service avoided acute hospital admissions.

DESIGN:

Observational study.

SETTING:

A two-bed municipal acute bed unit.

SUBJECTS:

All patients admitted to the unit between 2013 and 2016.

MAIN OUTCOME MEASURES:

Demographics, comorbidity, main diagnoses and level of municipal care on admission and discharge, diagnostic and therapeutic initiatives, MAU occupancy rate, and acute hospital admission rate.

RESULTS:

Altogether, 389 admissions occurred, 215 first-time admissions and 174 readmissions. The mean MAU bed occupancy rate doubled from of 0.26 in 2013 to 0.50 in 2016, while acute hospital admission rates declined. The patients (median age 84.0 years, 48.9% women at first time admission) were most commonly admitted for infections (28.0%), observation (22.1%) or musculoskeletal symptoms (16.2%). Some 52.7% of the patients admitted from home were discharged to a higher care level; musculoskeletal problems as admission diagnosis predicted this (RR =1.43, 95% CI 1.20-1.71, adjusted for age and sex).

CONCLUSION:

Admission rates to MAU increased during the first years of operation. In the same period, there was a reduction in acute hospital admissions. Patient selection was largely in accordance with national and local criteria, including observational stays. Half the patients admitted from home were discharged to nursing home, suggesting that the unit was used as pathway to a higher municipal care level. 

 

Tittel

Evaluation of municipal emergency care beds

Vitenskapelig sammendrag

OBJECTIVE:

To evaluate the use of a small municipality acute bed unit (MAU) in rural Norway resulting from the Coordination reform regarding occupancy-rate, patient characteristics and healthcare provided during the first four years of operation. Further, to investigate whether implementation of the new municipal service avoided acute hospital admissions.

DESIGN:

Observational study.

SETTING:

A two-bed municipal acute bed unit.

SUBJECTS:

All patients admitted to the unit between 2013 and 2016.

MAIN OUTCOME MEASURES:

Demographics, comorbidity, main diagnoses and level of municipal care on admission and discharge, diagnostic and therapeutic initiatives, MAU occupancy rate, and acute hospital admission rate.

RESULTS:

Altogether, 389 admissions occurred, 215 first-time admissions and 174 readmissions. The mean MAU bed occupancy rate doubled from of 0.26 in 2013 to 0.50 in 2016, while acute hospital admission rates declined. The patients (median age 84.0 years, 48.9% women at first time admission) were most commonly admitted for infections (28.0%), observation (22.1%) or musculoskeletal symptoms (16.2%). Some 52.7% of the patients admitted from home were discharged to a higher care level; musculoskeletal problems as admission diagnosis predicted this (RR =1.43, 95% CI 1.20-1.71, adjusted for age and sex).

CONCLUSION:

Admission rates to MAU increased during the first years of operation. In the same period, there was a reduction in acute hospital admissions. Patient selection was largely in accordance with national and local criteria, including observational stays. Half the patients admitted from home were discharged to nursing home, suggesting that the unit was used as pathway to a higher municipal care level. 

prosjektdeltakere

prosjektleder
Aktiv cristin-person

Sabine Ruths

  • Tilknyttet:
    Prosjektleder
    ved NORCE Helse - Allmennmedisin ved NORCE Norwegian Research Centre AS
  • Tilknyttet:
    Prosjektdeltaker
    ved NORCE Helse - Allmennmedisin ved NORCE Norwegian Research Centre AS

Anne Kjær Schmidt

  • Tilknyttet:
    Prosjektdeltaker
    ved NORCE Helse - Allmennmedisin ved NORCE Norwegian Research Centre AS

Thomas Mildestvedt

  • Tilknyttet:
    Prosjektdeltaker
    ved Universitetet i Bergen

Valborg Baste

  • Tilknyttet:
    Prosjektdeltaker
    ved NORCE Helse ved NORCE Norwegian Research Centre AS
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Resultater Resultater

First four years of operation of a municipal acute bed unit in rural Norway.

Schmidt, Anne Kjær; Lilleeng, Bård Flattun; Baste, Valborg; Mildestvedt, Thomas; Ruths, Sabine. 2018, Scandinavian Journal of Primary Health Care. LUSTER, NORCE, UIBVitenskapelig artikkel
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