Erratum to ‘Measuring appropriate use of acute beds: A systematic review of methods and results’

McDonagh, Marian; Smith, David H.; Goddard, Maria

doi:10.1016/s0168-8510(00)00117-2

Cited by 81 publications

(118 citation statements)

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“…22,[27][28][29][30] Our findings might have some clinical implications in designing models of care for older vulnerable patients and highlight the urgency to implement models of continuity of care for these patients in order to reduce the unnecessary recourse to hospital services. As care for older demented patients should include either shortterm acute hospital stay or long-term nursing home care as required, the present findings suggest that the availability of preferential or "fast" admission procedures to nursing homes from emergency departments or acute internal wards for these patients without acute severe comorbidity might consistently reduce the burden of prolonged and unnecessary hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of and factors associated with prolonged length of stay in older hospitalized medical patients

Fonte

Pivaro

et al. 2015

Geriatrics Gerontology Int

105

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Aim:To characterize elderly medical patients and identify factors associated with prolonged length of stay. Methods:The present prospective observational study evaluated consecutive patients aged ≥65 years admitted in acute geriatric and medical wards. A comprehensive assessment including demographic, clinical, functional and cognitive variables was carried out. Delayed discharge was defined when patients were discharged later than the date they were deemed medically ready for discharge by physicians. The analysis was initially carried out on the total sample and subsequently according to whether hospital admission had been from home, or from intermediate or long-term facilities.Results: Among 1568 patients (age 81.3 ± 7.3 years, 712 men), we observed a high prevalence of functional dependence, cognitive impairment, chronic immobilization and frailty (50%, 25%, 20% and 40%, respectively). Overall, delayed discharge occurred in 442 cases -resulting in 2637 days of prolonged hospital stay -and was independently associated with impairment in activities of daily living, frailty, high comorbidity and inappropriate admission. Among patients admitted from home (roughly 90% of the sample), delayed discharge occurred in 392 patients, and was independently associated with cognitive impairment, functional dependence, low severity of comorbidity and inappropriate admission (OR 3.39). Among patients admitted from intermediate or long-term facilities, lower cognitive impairment and greater severity of functional dependence were independently associated with prolonged stay. Conclusions:Poor health conditions and high prevalence of geriatric syndromes are extremely common among older medical inpatients. Delayed discharge was mainly observed in patients admitted from home, and associated with cognitive impairment (OR 1.12) and functional dependence (OR 1.49). Geriatr Gerontol Int 2015; 16: 314-321.

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Section: Discussionmentioning

confidence: 99%

Prevalence of and factors associated with prolonged length of stay in older hospitalized medical patients

Fonte

Pivaro

et al. 2015

Geriatrics Gerontology Int

105

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“…Yet our results seem to show the high clinical efficiency of a QDU depending on an internal medicine department of a tertiary hospital and further confirm the high degree of patient satisfaction and acceptance of this type of unit. As seen in the application of the AEP in matching hospital admissions, 19,20 the fact that the physician in charge of the QDU is the same who determines the appropriateness of the referral may introduce a bias that tends to overestimate the inadequacies, which is another limitation. The same is true for the proportion of…”

Section: 17mentioning

confidence: 99%

A quick diagnosis unit as an alternative to conventional hospitalization in a tertiary public hospital: a descriptive study

Sanclemente-Ansó¹,

Salazar²,

Bosch³

et al. 2013

Polish Archives of Internal Medicine

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“…Previous studies 17,[21][22][23][24] have also shown that older age, cognitive impairment, 23,24 functional dependence, 23 as well as the presence of multiple comorbidities and physical illnesses 25 were associated with longer hospital LOS for psychiatric patients. Additionally, diagnoses of schizophrenia, 26,27 psychotic or mood disorders, 21,22 and the presence of aggression or agitation 26 are associated with longer hospital stays.…”

mentioning

confidence: 97%

“…36,37 Further, the number of other placement options capable of providing optimal care (that is, rehabilitation, home care, and [or] community services) is insufficient to adequately respond to the demand. 1,17,30,31 This, in part, explains why psychiatric patients remain in hospital longer, compared with nonpsychiatric patients. 30 Moreover, discharge options are sometimes limited for patients with multiple medical and psychiatric comorbidities, who have complex needs.…”

mentioning

confidence: 99%

Characteristics and Needs of Psychiatric Patients with Prolonged Hospital Stay

et al. 2015

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Objective: To describe the characteristics and needs prior to, on admission, during the first month in hospital, at the thirtieth day of hospitalization and posthospital discharge of psychiatric patients occupying acute beds.Methods: This prospective observational study was conducted in 2 tertiary care hospitals. Adult patients hospitalized on a psychiatric unit for 30 days were identified. Data was collected from their medical charts and interviews with their health care team. The categorization of acute and nonacute status at day 30 was based on the health care professional's evaluation. Descriptive and univariate analyses were performed.Results: A total of 262 patients were identified (mean age 45 years), 66% lived at home and 11% were homeless. More than one-half were cognitively impaired and a few had special medical needs. Ninety-seven per cent had been admitted from the emergency department. At day 30, 81% of patients required acute care, while 19% (95% CI 15% to 24%) occupied an acute care bed, despite the resolution of their acute condition. The main reason preventing discharge of nonacute patients was the difficulty or inability to find appropriate resources that met patients' needs. As for patients who required acute care, the most common psychiatric issues were delusions or hallucinations (34%), inability to take medications independently (23.6%), and inadequate control of aggression or impulsivity (16.5%). Conclusions:Prevention of the discharge of nonacute patients is largely due to the difficulty in finding appropriate resources that meet patients' needs. Improved access to community and subacute care resources could potentially facilitate the hospital discharge of psychiatric nonacute patients. W W W Caractéristiques et besoins des patients psychiatriques dont le séjour à l'hôpital est prolongéObjectif : Décrire les caractéristiques et les besoins, avant l'hospitalisation, au moment de l'admission, durant le premier mois, au 30 e jour d'hospitalisation et après le congé de l'hôpital de patients psychiatriques occupant des lits de soins actifs.Méthode : Cette étude d'observation prospective a été menée dans 2 hôpitaux de soins tertiaires. Les patients adultes hospitalisés dans une unité psychiatrique pendant 30 jours ont été identifiés. Les données ont été recueillies dans leurs dossiers médicaux et par des entrevues avec leur équipe de soins de santé. La catégorisation du statut aigu et non aigu au 30 e jour se fondait sur l'évaluation des professionnels de la santé. Des analyses descriptives et univariées ont été exécutées.Résultats : Un total de 262 patients ont été identifiés (âge moyen 45 ans), dont 66 % vivaient à la maison et 11 % étaient sans abri. Plus de la moitié étaient cognitivement déficients et quelques-uns avaient des besoins médicaux spéciaux. Quatre-vingt

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Erratum to ‘Measuring appropriate use of acute beds: A systematic review of methods and results’

Cited by 81 publications

References 0 publications

Prevalence of and factors associated with prolonged length of stay in older hospitalized medical patients

Prevalence of and factors associated with prolonged length of stay in older hospitalized medical patients

A quick diagnosis unit as an alternative to conventional hospitalization in a tertiary public hospital: a descriptive study

Characteristics and Needs of Psychiatric Patients with Prolonged Hospital Stay

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