| Abstract | Uvod: Produljeni životni vijek te porast incidencije kroničnih bolesti rezultiraju većom potrebom za palijativnom skrbi. Cilj rada je ispitati povezanost indikatora kvalitete zdravstvene njege i zdravstvenih ishoda. Metode: U ovom retrospektivnom istraživanju analizirali su se zdravstvenih ishodi u pacijenata s dijagnozom Z51.5 preminulih u Psihijatrijskoj bolnici Ugljan u razdoblju od 2018. do 2023.godine. Ispitanici su podijeljeni u dvije skupine: pacijenti s demencijom (N=100) i pacijenti s drugim dijagnozama (kronične, maligne i psihičke bolesti) (N=97). Za ispitivanje razlika među skupinama korišten je Mann-Whitneyev U test i Hi-kvadrat test. Multivarijatna linearna regresija korištena za analizu povezanosti među varijablama. Rezultati: U ispitanika s demencijom (Me=46,0; IQR=75,0) zabilježen je dulji boravak u bolnici u odnosu na one s drugim dijagnozama (Me=26,0; IQR=86,0), p=0,014. Nije pronađena razlika u trajanju dijagnoze Z51.5 među skupinama (p=0,102). Ispitanici s drugim dijagnozama (54,6%) su češće razvijali nepokretnost (76,3%; p=0,043) i dekubitus (45,4%; p=0,017). Nije pronađena razlika u pojavnosti otežanog hranjenja (p=0,772), uroinfekcija (p=0,652) i pneumonija (p=0,383). Pronađena je povezanost između duljine hospitalizacije i dijagnoze Z51.5 (β=0,49; p<0,001) te nepokretnosti s duljinom hospitalizacije (β=-0,27; p<0,001) i dijagnozom Z51.5 (β=0,20; p=0,005). Starija dob bila je povezana s kraćom hospitalizacijom (β=-0,17; p=0,016). Ostale povezanosti između duljine hospitalizacije, dijagnoze Z51.5, indikatora kvalitete zdravstvene njege i negativnih zdravstvenih ishoda nisu pronađene. Zaključak: Povezanost između duljine trajanja hospitalizacije, dijagnoze i nepokretnosti, uz izostanak povezanosti s negativnim zdravstvenim ishodima ukazuje da učinkovite preventivne mjere mogu pozitivno utjecati na zdravstveno stanje pacijenata. Edukacija o značaju prevencije može značajno doprinijeti kvaliteti zdravstvene njege u ustanovama palijativne skrbi. |
| Abstract (english) | Introduction: Increased life expectancy and the rising incidence of chronic diseases result in a greater need for palliative care. The aim of this study is to examine the association between healthcare quality indicators and health outcomes. Methods: In this retrospective study, health outcomes were analyzed in patients with a diagnosis of Z51.5 who passed away at the Psychiatric Hospital Ugljan between 2018 and 2023. The subjects were divided into two groups: patients with dementia (N=100) and patients with other diagnoses (chronic, malignant, and psychiatric diseases) (N=97). The Mann-Whitney U test and Hi-square test were used to assess differences between the groups. Multivariate linear regression was used to analyze the associations between variables. Results: Dementia patients (Me=46.0; IQR=75.0) had a longer hospital stay compared to those with other diagnoses (Me=26.0; IQR=86.0), p=0.014. No difference was found in the duration of the Z51.5 diagnosis between the groups (p=0.102). Patients with other diagnoses (54.6%) more frequently developed immobility (76.3%; p=0.043) and bedsores (45.4%; p=0.017). No difference was found in the incidence of feeding difficulties (p=0.772), urinary infections (p=0.652), or pneumonia (p=0.383). An association was found between the length of hospitalization and the Z51.5 diagnosis (β=0.49; p<0.001), as well as between immobility and the length of hospitalization (β=-0.27; p<0.001) and the Z51.5 diagnosis (β=0.20; p=0.005). Older age was associated with a shorter hospital stay (β=-0.17; p=0.016). No other associations were found between the length of hospitalization, the Z51.5 diagnosis, healthcare quality indicators, and negative health outcomes. Conclusion: The association between the length of hospitalization, diagnosis, and immobility, along with the absence of a connection with negative health outcomes, suggests that effective preventive measures can positively influence the health status of patients. Education on the importance of prevention can significantly contribute to the quality of healthcare in palliative care facilities. |
