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Heilsa og lifun íbúa fyrir og eftir setningu strangari skilyrða fyrir flutningi á hjúkrunarheimili 2007

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Authors
Ingibjörg Hjaltadóttir
Kjartan Ólafsson
Árún K. Sigurðardóttir
Ragnheiður Harpa Arnardóttir
Issue Date
2019-10

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Other Titles
Health and survival in Icelandic nursing homes 2003 – 2014, before and after the setting of stricter criteria for nursing home admission in December 2007
Citation
Heilsa og lifun íbúa fyrir og eftir setningu strangari skilyrða fyrir flutningi á hjúkrunarheimili 2007. 2019, 105(10): 435-441 Læknablaðið
Abstract
INNGANGUR Fjölmargir þættir hafa áhrif á þjónustuþörf og lifun íbúa hjúkrunarheimila, meðal annars inntökuskilyrði fyrir flutningi á hjúkrunarheimili. Markmið rannsóknarinnar var að athuga hvort munur væri á heilsufari, lifun og forspárgildi mismunandi heilsufars- og færnivísa fyrir eins og tveggja ára lifun þeirra sem fluttu inn á íslensk hjúkrunarheimili á árunum 2003-2007 annars vegar og 2008-2014 hins vegar. EFNIVIÐUR OG AÐFERÐIR Lýsandi, afturskyggn samanburðarrannsókn. Gögnin fengust úr gagnagrunni á vegum Embættis landlæknis yfir allar interRAI-matsgerðir á íslenskum hjúkrunarheimilum frá 1. janúar 2003 til og með 31. desember 2014 (N=8487). NIÐURSTÖÐUR Marktækur munur var á heilsu og lifun nýrra íbúa hjúkrunarheimila fyrir og eftir 31. desember 2007. Á seinna tímabilinu var meðalaldur 82,7 ár, en 82,1 ár á hinu fyrra og tíðni Alzheimer-sjúkdóms, blóðþurrðarsjúkdóms í hjarta, hjartabilunar, sykursýki og langvinnrar lungnateppu jókst. Eins árs lifun lækkaði úr 73,4% í 66,5% eftir 1. janúar 2008 og tveggja ára lifun úr 56,9% í 49,1%. Sterkustu áhættuþættirnir fyrir dauðsfalli innan eins og tveggja ára frá komu á báðum tímabilum voru sjúkdómsgreiningarnar hjartabilun og langvinn lungnateppa, auk fleiri stiga á lífskvarðanum og langa ADL-kvarðanum. ÁLYKTUN Í kjölfar reglugerðarbreytingar 2007 voru þeir sem fluttu á hjúkrunarheimili eldri og veikari við komu og lifðu skemur eftir vistaskiptin en þeir sem fluttu inn fyrir breytingu. Niðurstöðurnar benda til að markmið reglugerðarbreytingarinnar, að forgangsraða þeim sem voru veikastir, hafi því náðst. Því má telja líklegt að umönnunarþörf íbúa sé önnur og meiri en áður.
Introduction: Many factors influence the nursing needs and survival of nursing home residents, including the admission criteria. The aim of the study was to compare health, survival and predictors for one- and two-year survival of people entering Icelandic nursing homes between 2003–2007 and 2008–2014. Material and methods: Retrospective, descriptive, comparative study. The data was obtained from a Directorate of Health database for all interRAI assessments of Icelandic nursing homes from January 1, 2003, to December 31, 2014 (N = 8487). Results: There was a significant difference in the health and survival of new nursing home residents before and after December 31, 2007. In the latter period, the mean age was 82.7 years. In the previous period, it was 82.1 years, and the prevalence of Alzheimer‘s disease, ischemic heart disease, heart failure, diabetes and COPD increased between the periods. One-year survival decreased from 73.4% to 66.5%, and two-year survival decreased from 56.9% to 49.1%. The strongest mortality risk factors were heart failure and chronic obstructive pulmonary disease, as well as high scores on the CHESS scale and ADL long scale. Conclusion: After 2007, new residents were older, in poorer health, and their life expectancy was shorter than for those moving to nursing homes before that. The results suggest that the aim of the regulatory change was achieved, i.e., to prioritise those in worst health. Their care needs may therefore be different and greater than before.
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https://www.laeknabladid.is/tolublod/2019/10/nr/7142
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Icelandic Journal Articles (Peer Reviewed)

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