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
ISSN: 13561294





JOURNAL OF EVALUATION IN CLINICAL PRACTICE
Editorial
WILEY, 111 RIVER ST, HOBOKEN 07030-5774, NJ USA, Reino Unido
Tipo de documento: Article
Volumen: 31 Número: 2
Páginas:
WOS Id: 001295328900001
ID de PubMed: 39167727
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