出版社：Norsk forening for epidemiologi - The Norwegian Epidemiological Association
摘要：ABSTRACTObjective: Design: Setting: Subjects: Intervention: Main outcome measures: Results: Conclusions: Key words: Home help; elderly; case-finding; general loss of function; long-term care; randomizedcontrolled trialHome helps can detect and communicate to a doctor functional decline and clinicalmanifestations of disease among their elderly clients. The study indicated, but provided no definiteevidence, that direct referral from home helps to a hospital-based general practitioner can keep elderlypeople at home longer.51 (45.1%) of the intervention subjects were referred once or more often, 110 referrals in all.General loss of function was the most frequent cause, and in all but six referrals specific diagnoseswere made. Home helps' referrals of patients with infection and stroke corresponded with the finaldiagnoses. After the first year of the study, the percentage of clients continuing to live at home washigher in the intervention group (P = 0.05 after adjustment for baseline differences in age and gender),mortality was similar, and use of hospital beds higher in the intervention group.Causes of referral, ICD-9 diagnostic categories, time under surveillancebefore long-term care or death, use of community services and hospital beds.Home helps were trained to recognize signs of functional and mental impairment andasked to call the study doctor when new medical or functional problems were identified. The interventionlasted for two years with an additional year for observation.Home help clients, 75 years or older, 113 in the intervention group and 161 in the comparisongroup.Community health services and a hospital-based general practice.Open study with quasi-experimental design. Randomization took place at the level of theorganizational units of home helps.To study the effect of early intervention in health problems identified by home helps.
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