Too many heart patients discharged without follow-up care
http://www.100md.com
《英国医生杂志》
Too many patients who are treated in hospital for heart disease are being discharged without appropriate advice on how they can improve their health and with little follow-up care, show results of a patient survey done by the NHS inspection body, the Healthcare Commission.
Responses to a postal questionnaire completed by almost 4000 patients who had been hospitalised with coronary heart disease show that nearly half of the people who had had a heart attack or angioplasty had not taken part in a cardiac rehabilitation programme. Overall, 63% of cardiac patients treated in English NHS trusts had not had any formal rehabilitation, and 37% were not on a regular programme to have their heart checked, either by their GP or at a hospital.
Advice from hospital staff about what lifestyle changes patients could make to reduce their chances of another coronary event was also patchy. Nearly half of patients were not given any advice about how they could change their diet; more than a third received no information about exercise; and 41% of smokers were not told about specialist services that they could access to help them quit.
The Healthcare Commission did the survey to gauge the progress that had been made in the care of cardiac patients since the implementation of the framework for coronary heart disease in 2000. Patients from about a third of acute trusts in England took part in the survey, which had a 75% response rate.
Although a progress report published by the commission in March showed that coronary heart disease was being treated more promptly and was helping to save lives ( BMJ 2005;330: 558), the present survey showed that there were gaps in the follow-up care of patients, said Anna Walker, chief executive of the Healthcare Commission.
"It is very concerning indeed that some heart patients are reporting to us that they are not getting the advice and aftercare they need to recover as fully as possible and enjoy the best possible quality of life," she said.(Zosia Kmietowicz)
Responses to a postal questionnaire completed by almost 4000 patients who had been hospitalised with coronary heart disease show that nearly half of the people who had had a heart attack or angioplasty had not taken part in a cardiac rehabilitation programme. Overall, 63% of cardiac patients treated in English NHS trusts had not had any formal rehabilitation, and 37% were not on a regular programme to have their heart checked, either by their GP or at a hospital.
Advice from hospital staff about what lifestyle changes patients could make to reduce their chances of another coronary event was also patchy. Nearly half of patients were not given any advice about how they could change their diet; more than a third received no information about exercise; and 41% of smokers were not told about specialist services that they could access to help them quit.
The Healthcare Commission did the survey to gauge the progress that had been made in the care of cardiac patients since the implementation of the framework for coronary heart disease in 2000. Patients from about a third of acute trusts in England took part in the survey, which had a 75% response rate.
Although a progress report published by the commission in March showed that coronary heart disease was being treated more promptly and was helping to save lives ( BMJ 2005;330: 558), the present survey showed that there were gaps in the follow-up care of patients, said Anna Walker, chief executive of the Healthcare Commission.
"It is very concerning indeed that some heart patients are reporting to us that they are not getting the advice and aftercare they need to recover as fully as possible and enjoy the best possible quality of life," she said.(Zosia Kmietowicz)