Factors associated with discharge home in older patients admitted to emergency department observation units: Looking for a predictive scale
Por:
Montero-Pérez, FJ, Bajo-Fernández, I, Castillo, JGD, Burillo-Putze, G, Jacob, J, Aguiló, S, Pinera-Salmerón, P, Alquezar-Arbé, A, Fernández-Alonso, C, Llorens, P, Cho, JUH, Casado-Ramón, B, Gayoso-Martín, S, Sánchez-Sindín, G, Fernández-Alvarez, ME, Gallardo-Vizcaíno, P, Romero-Carrete, C, Llauger, L, Vázquez-Rey, V, Calle-Fernández, S, Cañete, M, Ruescas, E, Fernández-Salgado, F, Miró, O
Publicada:
1 mar 2025
Ahead of Print:
1 ago 2024
Resumen:
Objectives: Primary care physician-led community hospitals provide basic hospital care for older people in Finland. Yet little is known of the outcomes of the care. We investigated factors associated with discharge destination after hospitalization in a community hospital and the role of active rehabilitation during the stay. Design: Prospective observational study. Setting and participants: Short-term community hospital stays of older adults (>= 65 years) living in the Kuopio University Hospital district in central and eastern Finland. Methods: Data on short-term (1-31 days) hospital stays from 51 community hospitals were collected with an electronic survey between January and June 2016. Physicians, secretaries, and rehabilitation staff from each community hospital completed the data collection form. Discharge destination was defined as home, residential care or death, and active rehabilitation as frequency of rehabilitation at least once a day. Analyses were conducted using the Bayesian approach and the BayesiaLab 9.1 tool. Results: Data of 11,628 community hospital stays were analyzed. The patients' mean age was 81.6 years (SD 7.9), and 57.5% were women. A younger age (65-74 years), a high number of rehabilitation staff (> 2 per 10 patients), and receiving rehabilitation at least once a day were associated with discharging patients to their own homes. Daily rehabilitation was associated with returning to home in all patient groups. Conclusions and implications: Older patients admitted to a community hospital for any reason may benefit from active rehabilitation. The role of community hospitals in the acute care and rehabilitation of older patients is important in aging societies.
Filiaciones:
Montero-Pérez, FJ:
Hosp Univ Reina Sofia, Emergency Dept, Cordoba, Spain
Bajo-Fernández, I:
Hosp Univ Reina Sofia, Emergency Dept, Cordoba, Spain
Castillo, JGD:
Complutense Univ, Hosp Clin San Carlos, Emergency Dept, IDISSC, Tenerife, Canary Islands, Spain
Burillo-Putze, G:
Univ La Laguna, Hosp Univ Canarias, Emergency Dept, Tenerife, Canary Islands, Spain
Jacob, J:
Hosp Univ Bellvitge, Emergency Dept, Lhospitalet De Llobregat, Barcelona, Spain
Aguiló, S:
Univ Barcelona, Hosp Clin, Emergency Dept, IDIBAPS, Barcelona, Spain
Pinera-Salmerón, P:
Hosp Reina Sofia, Emergency Dept, Murcia, Spain
Alquezar-Arbé, A:
Hosp Santa Creu & Sant Pau, Emergency Dept, Barcelona, Spain
Fernández-Alonso, C:
Complutense Univ, Hosp Clin San Carlos, Emergency Dept, IDISSC, Tenerife, Canary Islands, Spain
Llorens, P:
Hosp Gen Univ Dr Balmis, Emergency Dept, Inst Invest Sanitaria & Biomed Alicante ISABIAL, Alicante, Spain
Univ Miguel Hernandez, Clin Med Dept, Elche, Spain
Cho, JUH:
Hosp Mendaro, Emergency Dept, Gipuzkoa, Spain
Casado-Ramón, B:
Hosp Miguel Servet, Emergency Dept, Zaragoza, Spain
Gayoso-Martín, S:
Hosp Comarcal El Escorial, Emergency Dept, Madrid, Spain
Sánchez-Sindín, G:
Hosp Salnes, Emergency Dept, Vilagarcia De Arousa, Pontevedra, Spain
Fernández-Alvarez, ME:
Hosp Barbanza, Emergency Dept, Ribeira, A Coruna, Spain
Gallardo-Vizcaíno, P:
Hosp del Mar, Emergency Dept, Barcelona, Spain
Romero-Carrete, C:
Hosp Santa Creu & Sant Pau, Emergency Dept, Barcelona, Spain
Llauger, L:
Hosp Vic, Emergency Dept, Barcelona, Spain
Vázquez-Rey, V:
Hosp Nalon, Emergency Dept, Langreo, Asturias, Anguilla
Calle-Fernández, S:
Hosp Altagracia, Emergency Dept, Manzanares, Ciudad Real, Spain
Cañete, M:
Hosp Nuestra Senora Prado, Emergency Dept, Talavera De La Reina, Toledo, Spain
Ruescas, E:
Hosp Univ Vinalopo, Emergency Dept, Elche, Alicante, Spain
Fernández-Salgado, F:
Hosp Mostoles, Emergency Dept, Mostoles, Madrid, Spain
Miró, O:
Univ Barcelona, Hosp Clin, Emergency Dept, IDIBAPS, Barcelona, Spain
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