167 An Alternative to the Emergency Department for Frail Older People
| Autor: | Siobhan Kennelly, Elaine Shanahan, Alisa Antonenko, Chie Wei Fan, Frances McCarthy |
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| Rok vydání: | 2019 |
| Předmět: | |
| Zdroj: | Age and Ageing. 48:iii17-iii65 |
| ISSN: | 1468-2834 0002-0729 |
| Popis: | Background 53% of hospital inpatient beds are occupied by patients >/= 65 years. These patients often experience functional decline. In those transferred to our post-acute rehabilitation unit the average length of stay prior to transfer is 16 days and 38 days post transfer. Our hospital has a Community Response Unit (CRU) which provides an alternative to this care pathway, offering direct admission to a 15 bed unit with 24-hour medical cover and full multidisciplinary input. This study reviews the use of this unit over a one year period. Methods We retrospectively reviewed the discharge letter or medical notes of patients admitted to the CRU during 2018. The referral source, indication for admission, length of stay and discharge destination were recorded. Results One-hundred and fourteen patients were admitted over the one year period. Source of referral was identified for 81 patients and included day hospitals (53.1%), acute hospitals (14.8%), respite/ transitional care wards (12.3%), nursing homes (8.7%), home visits (6.2%), community sources (3.7%) and other speciality clinics (1.2%). The most common indications for admission were-mobility/functional decline (26.3%), falls (17.5%), requirement for medical investigations (14.9%), cognitive decline with behavioural issues (11.4%), blood transfusion (10.5%), pain management (7%), general deterioration (7%), requirement for increased home supports (7%), treatment of infection (6.1%), rehab post fracture (5.3%), wound management (4.4%), alcohol detoxification (1.8%) and self-neglect (1.8%). Multifactorial reasons for admission frequently occurred. The median length of stay was 24 days (1-176 days), 67% of patients were discharged to their original residence, 17.4% were newly admitted to residential care, 9.2% required transfer to an acute hospital and 6.4% died during their admission. Conclusion The CRU provides comprehensive Geriatrician led care for a wide variety of indications. This model of care offers a valid alternative to Emergency Department presentation and acute hospital admission. |
| Databáze: | OpenAIRE |
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