TY - JOUR T1 -早期姑息性家庭护理与以患者为中心的医疗资源利用和慢性阻塞性肺病患者死亡前30天内的较低成本有关:一个群体被继承人队列研究摩根富林明-欧洲呼吸杂志》乔和J - 10.1183/13993003.01139 -2019欧元SP - 1901139 AU -舍林,夏洛特盟——西班牙,克里斯托夫盟——Pype彼得盟——Beernaert金盟——乔斯,人非盟- Derom Eric AU -科恩,约阿希姆AU - Deliens Luc盟——Chambaere Kenneth Y1 - 2020/01/01 UR - //www.qdcxjkg.com/content/early/2020/02/20/13993003.01139 - 2019. -抽象N2 -背景慢性阻塞性肺病患者经常使用许多医疗资源,如入院和医学影像检查，不合时宜地接近死亡。缓和家庭护理(Palliative home care, PHC)可有效影响his。目的研究慢性阻塞性肺疾病(COPD)死亡前30天(DBD) PHC使用及时机对医疗资源使用及费用的影响。方法回顾性研究2010-2015年比利时所有慢性阻塞性肺病患者的死亡，其主要死亡原因为慢性阻塞性肺病或心血管疾病。医疗资源的优势比(OR)在使用和四个PHC时间类别之间进行计算(>360;360 - 181;180 - 91;90-31 DBD)与未使用的比较。 Confounders were socio-demographic, care intensity and disease severity variables.Results Of the 58 527 decedents with COPD, 644 patients (1.1%) received PHC earlier than 30 DBD. Using PHC (versus not using) decreased the OR for hospitalisation (0.35), intensive care unit admission (0.16), specialist contacts (0.58), invasive ventilation (IV) (0.13), medical imaging including chest radiograph (0.34), sedatives (0.48) and hospital death (0.14). It increased the OR for home care (3.27), general practitioner contact (4.65), palliative care unit admission (2.61), non-IV (2.65), gastric tube (2.15), oxygen (2.22) and opioids (4.04) (p<0.001). Mean total healthcare costs were €1569 lower for using PHC. All PHC timing categories showed a benefit in medical resource use and costs. However, we observed the largest benefit in the category PHC 90–31 DBD.Conclusion Health policy and services should focus on increasing PHC access, while research should further explore early PHC initiation for COPD. Funding SBO IWT nr. 140009.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Scheerens has nothing to disclose.Conflict of interest: Dr. Faes has nothing to disclose.Conflict of interest: Dr. Pype has nothing to disclose.Conflict of interest: Dr. Beernaert has nothing to disclose.Conflict of interest: Dr. Joos has nothing to disclose.Conflict of interest: Dr. Derom has nothing to disclose.Conflict of interest: Dr. Cohen has nothing to disclose.Conflict of interest: Dr. Deliens has nothing to disclose.Conflict of interest: Dr. Chambaere has nothing to disclose. ER -