Biopsychosocial factors related to the length of hospital stay in older people

Guerrero, Laura Lorén; Gascón-Catalán, Ana

doi:10.1590/s0104-11692011000600014

Cited by 9 publications

(10 citation statements)

References 3 publications

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“…50 This characteristic has been found to be associated with longer hospitalization. 51,52 Cognitively impaired patients remaining on an acute psychiatric care unit present a major concern, mainly because these settings are often unable to adequately meet these patients' needs. 53,54 Finally, 8 patients in the nonacute group had a total hospital LOS of greater than 100 days, with 1 patient staying as long as 153 days.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

confidence: 99%

Characteristics and Needs of Psychiatric Patients with Prolonged Hospital Stay

et al. 2015

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“…Other factors associated with increased bed use include advanced old age [60,61], poor grip strength [62,63], other markers of frailty [64,65], atypical disease presentation [66], multiple co-morbidities [67,68], depression [69,70], cognitive impairment [71–74], poor functional status [75–77], development of pressure sores [78], low socio-economic status [79], lack of family support [80], loneliness [81] and living in a care home [82,83]. These underlying risks are inter-related, which may explain why many of the effective interventions identified in our study were multifaceted.…”

Section: Discussionmentioning

confidence: 99%

Reducing hospital bed use by frail older people: results from a systematic review of the literature

et al. 2013

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IntroductionNumerous studies have been conducted in developed countries to evaluate the impact of interventions designed to reduce hospital admissions or length of stay (LOS) amongst frail older people. In this study, we have undertaken a systematic review of the recent international literature (2007-present) to help improve our understanding about the impact of these interventions.MethodsWe systematically searched the following databases: PubMed/Medline, PsycINFO, CINAHL, BioMed Central and Kings Fund library. Studies were limited to publications from the period 2007-present and a total of 514 studies were identified.ResultsA total of 48 studies were included for full review consisting of 11 meta-analyses, 9 systematic reviews, 5 structured literature reviews, 8 randomised controlled trials and 15 other studies. We classified interventions into those which aimed to prevent admission, interventions in hospital, and those which aimed to support early discharge.ConclusionsReducing unnecessary use of acute hospital beds by older people requires an integrated approach across hospital and community settings. A stronger evidence base has emerged in recent years about a broad range of interventions which may be effective. Local agencies need to work together to implement these interventions to create a sustainable health care system for older people.

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“…(30)(31)(32)(33)(34). En este sentido, Guerrero y colaboradores evaluaron las variables que influyen en el aumento de la duración de la estancia hospitalaria en una valoración geriátrica integral a 81 personas mayores de 65 años de edad que ingresaron en un hospital de agudos de tercer nivel, evidenciando un aumento de la duración de la estancia entre los mayores de 80 años, las personas que vivían solas o en una residencia geriátrica, los pacientes que presentaban gran dependencia física y también, entre quienes tenían un riesgo o problema de exclusión social (35).…”

Section: Discussionunclassified

Análisis del riesgo de deterioro funcional y sociofamiliar en el adulto mayor hospitalizado

Torres

Rivera

Mendivelso

et al. 2019

Rev. Médica Sanitas

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Introducción: El adulto mayor es una persona vulnerable clínicamente, biológica, emocional y socialmente. El objetivo de este trabajo es identificar la prevalencia de riesgo de deterioro funcional, pérdida de autonomía y vulnerabilidad sociofamiliar en personas mayores hospitalizadas en una institución de salud. Metodología: Diseño de corte transversal con pacientes >65 años hospitalizados en institución de alta complejidad. Se excluyeron hospitalizados en unidad de cuidados intensivos, patología quirúrgica, oncológica y psiquiátrica. Los instrumentos de medición fueron aplicados mediante entrevista por trabajadoras sociales de la institución previo entrenamiento y estandarización en la técnica de entrevista. Se utilizó la escala de riesgo de deterioro funcional (HARP) y la versión abreviada y simplificada de la escala de valoración sociofamiliar de GIJÓN. Resultados: Evaluamos consecutivamente 981 pacientes durante un periodo de nueve meses en el servicio de hospitalización de adultos. Edad promedio del grupo 78 años, mayor prevalencia de mujeres (63%), alta frecuencia de casados (71%) y trabajadores jubilados o pensionados (82%). El 7,5% de los pacientes egresaron al programa de hospitalización domiciliaria. La prevalencia de riesgo deterioro funcional (HARP) fue del 50% con mayor compromiso en grupo de 85+ años (74%). La valoración de GIJÓN identificó limitación de recursos sociofamiliares en 4%. Discusión: La escala HARP y GIJÓN son instrumentos de fácil aplicación y complementan la valoración clínica del adulto mayor hospitalizado. Para los departamentos de atención al usuario y de asistencia social hospitalaria constituyen Revista Médica Sanitas 7 ANÁLISIS DEL RIESGO DE DETERIORO FUNCIONAL Y SOCIOFAMILIAR EN EL ADULTO MAYOR HOSPITALIZADO un estándar de calidad, dado que permiten conocer otras dimensiones como el entorno social, familiar, neuropsicológico y en algunos casos medio-ambientales en procura del cuidado integral.

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Biopsychosocial factors related to the length of hospital stay in older people

Cited by 9 publications

References 3 publications

Characteristics and Needs of Psychiatric Patients with Prolonged Hospital Stay

Characteristics and Needs of Psychiatric Patients with Prolonged Hospital Stay

Reducing hospital bed use by frail older people: results from a systematic review of the literature

Análisis del riesgo de deterioro funcional y sociofamiliar en el adulto mayor hospitalizado

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