Family doctor team care reduces morbidity of disabled elderly in home care / 中华全科医师杂志

ABSTRACT

Objective To assess the effect of family doctor team care on morbidity of disabled elderly in home care.Methods Eighty six disabled elderly patients with home care in Shanghai Xujiahui community were enrolled from February 2014 to January 2015.The patients were randomly divided into intervention group and control group with 43 cases in each.In intervention group,the family doctor team provided long-term,comprehensive and integrated care,and in control group the conventional home care was provided.The rates of morbidity and readmission to hospital were documented during the 3,6 and 12 monthfollow-up,and compared between two groups.Results The incidence rates of bedsore,pneumonia and deep vein thrombosis in intervention group was significantly lower than those in control group [after 6 months4.9％ (2/41) vs.28.9％(11/38),x2 =8.311;2.4％ (1/41) vs.21.1％ (8/38),x2 =6.769;2.4％ (1/41) vs.15.8％ (6/38),x2 =4.353,respectively;after 12 months2.4％ (1/41) vs.42.1％ (16/38),x2 =18.374;4.9％ (2/41)vs.28.9％ (11/38),x2 =8.311;7.3％ (3/41)vs.28.9％ (11/38),x2 =6.328,respectively;all P ＜0.05].The number of cases with bedsore healing(6/7 vs.0,x2 =18.555)and pneumonia recovery[5/6 vs.4.3％ (1/23),x2 =18.092] was significantly more and that with pneumonia deterioration (0 vs.52.2％ (12/23),x2 =5.340)was significantly less in intervention group than those in control group (all P ＜ 0.05).More cases with deep vein thrombosis improved(1/3 vs.0,x2 =3.949) and less cases with deep vein thrombosis deteriorated(0 vs.8/11,x2 =5.091) in intervention group than those in control group (P ＜ 0.05).And both the readmission rate for home care patients [2.4％ (1/41) vs.36.8％ (14/38),x2 =15.175] and for patients with complications [1/12 vs.43.8％ (14/38),x2 =4.872] was much lower in intervention group than that in control group (both P ＜ 0.05).Conclusion The family doctor team care can reduce the risk of complications and readmission to hospital,and also can improve the quality of life of home care disabled elderly,as well as reduce the burden of family and society.