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王淑鈴(Shu-Ling Wang); 謝佩穎(Pei-Yin Hsieh); 張晉豪(Chin-Hao Chang); 李啟明(Chii-Ming Lee); 林美蓉(Mei-Rong Lin); 鍾雨珍(Yu-Chen Chung)
台灣醫學, 11/2023, Volume: 27, Issue: 6Journal Article
心衰竭病人因液體容積過量引起呼吸困難、疲倦等症狀,其再住院率與死亡率皆高,本案為北台灣某醫學中心之心衰竭急性後期整合照護計畫(post-acute care program, PAC),期能改善心衰病人照護成效。為探討心衰竭個案接受PAC照護與否之成效差異。此回溯性縱向研究,納入2018年2月2日至2019年12月31日因心衰竭惡化而住院之受試者(n= 305),以其心專醫師具PAC證書為PAC組(n= 187),反之為非急性後期整合照護計畫組(n = 118)。結果顯示PAC組返診率較高(p=0.014)、急診就醫次數較低(p=0.011)、再住院發生較晚且全因死亡率較低,年齡越大死亡風險越高(p= 0.049)。PAC組較非PAC組存活平均延長20.2天(p = 0.020)。PAC照護之病人急性醫療需求下降、再住院發生時間較晚、死亡率降低且存活平均天數延長。本研究結果顯見以個管師為窗口且整合多專科團隊共同照護之下,對心衰竭病人具相當成效。
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