Chronic non-communicable diseases and personal history in readmitted patients and occupational therapy contribution

AbstractObjectivesTo identify non-communicable chronic diseases and personal history and the frequency of the latter in patients readmitted in a general hospital, as well as determine the contribution of occupational therapy in this context.MethodThe presented study included 544 participants readmitted in a General Hospital. Data were collected through semi-structured interviews and analysis of medical records.ResultsThe participants were predominantly elderly, male, married, retired, with schooling up to the 4th grade. Most of them presented two readmissions and the main reasons for the current hospitalization were respiratory diseases, pain, and urinary and surgical wound disorders. The most frequent personal history included hypertension and diabetes, with frequency of two individuals.DiscussionThis study showed a prevalence of elderly who, due to the aging process, use health services more often, with the consequent increase in admissions and readmissions and their high costs. There was a high percentage of chronic diseases and personal history. We identified the need for effective strategies and actions in the primary and secondary sectors to decrease the number of readmissions and their high costs. As part of the multidisciplinary team, the work of occupational therapists with this population becomes relevant through preventive actions with better cost-effectiveness.

摘要
## 研究目的
识别综合医院再入院患者的非传染性慢性病（non-communicable chronic diseases）、个人病史及后者的发生频率，并明确作业治疗（Occupational Therapy）在此临床场景中的应用价值。
## 研究方法
本研究共纳入544名综合医院再入院患者，研究数据通过半结构化访谈（semi-structured interviews）与病历分析（medical records analysis）两种方式采集。
## 研究结果
受试者以老年男性群体为主，多为已婚、退休状态，受教育程度不超过小学四年级。多数患者存在2次再入院史，本次住院的主要诱因为呼吸系统疾病、疼痛以及泌尿系统与手术伤口相关病症。最常见的个人病史为高血压与糖尿病，共有2名患者存在此类病史。
## 讨论
本研究发现，由于衰老进程，老年人群更频繁地利用医疗服务，由此导致入院与再入院次数增加，且医疗成本居高不下。本研究中慢性病与个人病史的占比颇高。研究证实，亟需在初级与二级医疗保健领域制定有效的策略与干预措施，以降低再入院次数及其高额医疗成本。作为多学科团队（multidisciplinary team）的一员，作业治疗师针对该人群开展的工作，通过具备更佳成本效益的预防措施，其临床相关性愈发凸显。