Benefits of Access to On‐site Acute and Critical Care for the Residential Section of a Multi‐level Geriatric Center

Abstract

Of 220 residents living in the residential unit of a multi-level geriatric center, 95 required a total of 131 transfers to other facilities over a one-year period. Fifty-three of these patients were transferred to the associated chronic-care hospital for short-term acute medical investigation or treatment. The average length of stay of 17 days was similar to that of patients of comparable age with comparable medical conditions admitted to an affiliated acute general hospital from the community. In addition to continuity of medical care and the social and psychologic advantages of remaining within the geriatric center, this transfer potential resulted in substantial financial savings. The cost of hospitalization in the general hospital would have been more than twice that of the geriatric unit.

An Acute Care Unit in a Multilevel Geriatric Facility: The First Two Years of the New Baycrest Hospital

“…The average length of stay in the combined CCU/SDU is 15.75 days for 1986/1987 and 20.19 days for 1987/1988 (18.17 days for 1988/1989). These figures are not that different from those of some general hospitals of between 200 to 399 beds, as reported in the Hospital Council of Metropolitan Toronto monthly report for February 1989, and only somewhat longer than the 17 days noted in the previous study that examined BT transfers to the old four‐bed hospital unit 4 …”

“…The Baycrest Centre for Geriatric Care is a multilevel facility, one component of which is the Baycrest Hospital. Unlike other “chronic care” hospitals in Toronto, it already had acute care ability on a limited scale until April 1986 4 . With the opening of the new Baycrest Hospital in 1986, its acute care potential expanded from 4 beds to 10 acute (concentrated care unit or CCU) and 17 subacute (step‐down unit or SDU) beds, which are housed on one subdivided nursing unit.…”

Transferal Patients from Long‐term Care Facilities

“…To the Editor: —We would like to thank Dr. Gordon for his interest in our recent paper 1 . We agree with Dr. Gordon that the facilities in their study 2 were different than in ours and we did not mean to imply that the institutions or patient populations they described were identical to ours. Because there is such a paucity of information regarding the transfer of patients from long‐term care facilities to acute care facilities, we felt it would be useful to include reference to work that was similar to, but not necessarily identical with, ours.…”

Aging‐Related Clinical and Health Services Research in Canada

“…Early research efforts were related largely to common clinical problems or were based on identifying service needs and describing new programs. Limited by resources and methods, these latter studies provided guides to the establishment of, for example, geriatric assessment units, 2,3 palliative care units, 4 respite care, 5,6 acute medical units in long‐term care facilities, 7 and long‐term care units in acute care hospitals 8 . Other reports described problems such as long‐stay patients 5 or noisy patients in long‐term care 10 .…”