合肥地区老年高血压急症患者对EMSS资源利用现状调查

Current status of EMSS resource utilization of elderly patients with hypertensive emergency in Hefei

目的通过对合肥地区高血压急症老年患者利用急诊医疗服务体系调查,为进一步规范EMSS资源管理和建设,优化资源配置提供科学依据。方法对2005年3月-2010年3月间在我院就诊的281例高血压急症患者的发病及EMSS资源利用情况进行回顾性调查。结果 EMSS资源利用率60～80岁老年患者为56.79%,80岁及以上患者为68.29%;城区居民为60.22%,农村居民为49.00%。就诊时症状非特异和伴有急慢性合并症60～79岁患者分别为121和130例,80岁以上患者65和68例,城区居民111和118例,农村居民为75和80例。结论 EMSS资源利用率显示,城区居民高于农村、80岁及以上患者利用率高,且30 d再住院率和病死率亦显著增多。入院病人以农村居民、80岁以上、非特异症状、合并急、慢性合并症患者较为多见。

Aim To study the resource utilization of EMSS for aged hypertension patients in Hefei,so as to provide theoretical foundation for standard management and development for EMSS resource,and for optimize resource allocation.Methods From March 2005 to March 2010,281 aged hypertension patients and their utilization of EMSS resources situation were investigated and analyzed retrospectively.Results 281 aged patients with hypertensive emergency were divided into elderly group（≥60 years old and 80 years old）and very elderly group（≥80 years old）.The situation of EMSS resource utilization in elderly group was higher than that in very elderly group（52.76% vs 68.29%,P0.05）,and patients from urban（60.22%）was higher than patients from rural（49.00%）（P0.05）.Mean length of hospital stay of patients without using EMSS resource was longer than those with EMSS resource utilization（P0.05）.The very elderly patients had higher rate of non-specific symptoms and co-morbidities（P0.01）,also longer average length of hospital stay,higher 30d readmission rate（P0.01）and mortality（P0.05）than the elderly patients.Meanwhile the patients from rural had higher rate of non-specific symptoms（P0.05）and co-morbidities（P0.01）than the patients from urban.Conclusion More utilization of EMSS resource is found in aged patients,and that of urban is higher than those from rural.The very elderly patients require more emergency care resources than elderly patients and their 30 d rehospitalization rate and mortality rate are higher significantly.The very elderly patients from rural show more nonspecific symptom and acute/chronic complication.