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标题：Mobile x-ray services; outcome for nursing home residents and society - a literature review
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作者：Elin Kjelle
期刊名称：International Journal of Integrated Care
电子版ISSN：1568-4156
出版年度：2016
卷号：16
期号：6
DOI：10.5334/ijic.2978
出版社：Utrecht University, Maastricht University, Groningen University
摘要：Introduction : Nursing home residents who are in need of radiological services usually transfers to hospital, even for x-ray examinations like chest or skeletal x-ray possible to provide with a digital mobile x-ray unit at site. Nursing home residents, and especially residents with dementia, needs familiar surroundings to feel safe. New surroundings like the x-ray department in a hospital may lead to increased anxiety or disorientation. To achieve person-centred processes in healthcare services the organization needs to facilitate person-centred care. The objective of this study is to summarize the benefits nursing home residents and the society in general gets for mobile x-ray services. Methods : A systematic literature search was performed in PubMed, Cinahl, AgeLine, EBSCOhost and SveMed+ databases in October 2015. Studies were eligible when reporting on mobile x-ray units serving nursing homes. The following search terms were used: Mobile radiography, Cost effectiveness, Nursing home, Portable radiography, Mobile health units and different combinations of these search phrases. A Google search gave access to a cost-effectiveness report from Norway. Articles in English, German and Norwegian were included. The author selected studies, assessed studies, and extracted data in the review. Results : Ten articles and one cost-effectiveness analysis were included in the review. The review shows mobile x-ray units set up in Australia, Italy, Switzerland, Sweden and Norway. Six studies shows mobile x-ray units to reduce the burden of transportation to hospital for chest, skeletal and abdominal x-ray examinations. Five studies reports reduction in hospitalizations or visits to the emergency room. Reduction in resourced used when staff accompany residents to hospital were found in six studies. One study and one cost-effectiveness analysis shows cost-effectiveness of mobile x-ray services in Norway, one study shows cost-effectiveness in Sweden. Discussion : Transfer of residents to hospital for simple x-ray examinations lead to a significant and partly unethical burden for nursing home residents, and especially those with dementia. Examinations performed locally in nursing homes reduced unnecessary anxiety and confusion, especially for residents with dementia. One study found 17% of the residents in their study examined at hospital developed delirium requiring treatment, were as none of the residents examined at home developed delirium. Included studies show mobile radiography services to decrease the need for hospitalization and transportation of nursing home residents. More patients receive treatment at the nursing home with reduction of medical complications after hospital treatment. Being in the nursing home the care environment are more suited for nursing home residents compared to the x-ray department or a hospital ward. Mobile x-ray services therefore can contribute to person-centred care processes in nursing homes. Mobile x-ray units might pose a need for knowledge in nursing homes on preparation for and carrying out x-ray procedures. Nursing homes might also needs increased knowledge in treatments usually given in hospitals.
关键词：mobile x-ray units ; nursing homes ; cost-effectiveness ; patient benfits ; digital radiography