Zusammenfassung
Hintergrund
Krankenhauseinweisungen von Menschen aus Pflegeheimen sind häufig. In dieser prospektiv-kontrollierten Studie wurden die Effekte eines internistisch-fachärztlichen, mobilen geriatrischen Konsiliardienstes (GEKO) auf die Häufigkeit von akuten Krankenhauseinweisungen von Pflegeheimbewohnern untersucht.
Methoden
Während der 10-monatigen Studienphase wurden die Bewohner des Kontrollpflegeheims medizinisch durch Hausärzte, die Bewohner des GEKO-Pflegeheims zusätzlich durch GEKO versorgt.
Ergebnisse
Im GEKO-Pflegeheim wurde eine statistisch signifikant niedrigere Anzahl akuter Krankenhauseinweisungen nachgewiesen (mittlere Anzahl pro 100 Bewohner pro Monat: 6,1 vs. 11,7; p < 0,01). Auch die Anzahl geplanter Krankenhaus- und Facharztzuweisungen war im GEKO-Pflegeheim niedriger als im Kontrollpflegeheim (mittlere Anzahl pro 100 Bewohner pro Monat: 14,4 vs. 18,0), die Differenz erreichte jedoch keine statistische Signifikanz.
Schlussfolgerung
Die Ergebnisse dieser Studie zeigen, dass ein internistischer, mobiler geriatrischer Konsiliardienst zu einer statistisch signifikanten Reduktion von akuten Krankenhauseinweisungen aus Pflegeheimen führt.
Abstract
Background
Hospital admissions are frequent among long-term residents of nursing homes and can result in detrimental complications affecting the patients’ somatic, psychological, and cognitive status. In this prospective controlled study, we investigated the effects of a mobile geriatric consultant service (GECO) offered by specialists in internal medicine on frequency of hospitalizations in nursing home residents.
Methods
During a 10-month observation period, residents in a control nursing home received medical attendance by general practitioners as is common in Austrian nursing homes. Residents in the intervention nursing home also received the medical service of GECO.
Results
Within the group of rest home residents receiving GECO support, a statistically significant lower frequency of acute transports to hospitals was observed in comparison to residents of the control nursing home (mean number of acute transports to hospitals/100 residents/month: 6.1 versus 11.7; p < 0.01). The number of planned non-acute hospital and specialist office presentations was also lower in the intervention nursing home (mean number of hospital and specialist office presentations/100 residents/month: 14.4 versus 18.0); however, this difference did not reach statistical significance.
Conclusion
This study shows that a mobile medical geriatric consultant service based on specialists in internal medicine can improve medical care in nursing homes resulting in a statistically significant reduction of acute transports to hospitals.
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Schippinger, W., Hartinger, G., Hierzer, A. et al. Mobiler geriatrischer Konsiliardienst für Pflegeheime. Z Gerontol Geriat 45, 735–741 (2012). https://doi.org/10.1007/s00391-012-0395-2
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DOI: https://doi.org/10.1007/s00391-012-0395-2