老年冠心病患者"社会化住院"现状及影响因素分析

Current status and influencing factors of"social hospitalization"among elderly coronary disease patients

目的:调查老年冠心病患者"社会化住院"现状,并分析其影响因素。方法:采用便利抽样法,选择南京医科大学第一附属医院心血管内科2018年1月—2019年6月收治的老年冠心病患者906例为研究对象。采用自行设计的社会化住院现状调查表对其进行调查。采用Logistic回归分析老年冠心病患者"社会化住院"的影响因素。共获得完整数据866份。结果:866例老年冠心病患者中,"社会化住院"患者252例,占29.09%;非"社会化住院"患者614例,占70.91%。Logistic回归分析显示,住院阶段转科室、出院标准时ADL水平、心功能分级、年龄、家庭人均收入、医院获得性感染、入院途径、合并其他慢性病、抑郁、焦虑、认知障碍、病程和公费、新农合及自费医保类型均是老年冠心病患者"社会化住院"的影响因素(P<0.05)。结论:老年冠心病患者达到出院标准时仍选择"社会化住院",其受到个人、家庭及社会医疗机构发展影响。

Objective To explore the current status of"social hospitalization"among elderly coronary disease patients and analyze its influencing factors.Methods From January 2018 to June 2019,this study selected 906 elderly coronary disease patients of Department of Cardiovascular Medicine in the First Affiliated Hospital with Nanjing Medical University as subjects by convenience sampling.All of patients were investigated with the self-designed Social Hospitalization Scale.Logistic regression analysis was used to analyze the influencing factors of"social hospitalization"among elderly coronary disease patients.A total of 866 complete data was collected.Results Among 866 elderly coronary disease patients,there were 252 of them with"social hospitalization"accounting for 29.09%and 614 with non"social hospitalization"accounting for 70.91%.Logistic regression analysis showed that the influencing factors of"social hospitalization"among elderly coronary disease patients included the department change during hospitalization,activities of daily living(ADL)up to the standard at discharge,heart function classification,ages,family per capita income,hospital-acquired infection,admission route,being combined with other chronic disease,depression,anxiety,cognitive impairment,disease course,medical insurance of public expense,new rural cooperative medical care and at patients own expense with statistical differences(P<0.05).Conclusions Elderly coronary disease patients still select the"social hospitalization"when up to the standard at discharge which influenced by the individual,family and social medical institution.