Elderly patients in acute medical wards: factors predicting length of stay in hospital.

Abstract

A prospective study of 419 patients aged 70 and over admitted to acute medical wards was carried out by medical staff from a geriatric unit. Data Although these factors are interrelated, the most important influence on length of stay was the medical reason for admission. Early contact with the geriatric medical unit in these patients may speed up the recovery or result in more appropriate placement. IntroductionCurrent demographic trends predict a continuing increase in the number of old people during the next two decades at least. This will have implications for the hospital services as elderly people are admitted to hospital more often and stay longer than those in younger age groups.2 The average length of stay includes the length of stay of some patients who recover quickly and leave hospital without delay and that of a small number of patients who stay in hospital a long time, sometimes referred to as "bed blockers." 34 The attachment of geriatricians to acute medical wards results in a reduction of the mean length of stay of elderly patients.5 Despite an input of "geriatric" skills, such as multidisciplinary assessment, early planning of discharge arrangements, and familiarity with local resources, however, some patients will probably have a prolonged hospital stay. If these patients could be identified soon after admission the appropriate resources could be made available at an early stage to try to speed up their rehabilitation or find an appropriate alternative placement.To identify those factors that could predict a prolonged length of stay in hospital, a prospective study of consecutive patients aged 70 and over admitted to the general wards of a Belfast teaching hospital was carried out.

Factors associated with prolonged length of stay in older patients

“…(6,33) Patient transfers to ILTC institutions may be delayed due to limited bed availability and administrative delays in the referral process. It is hoped that, as ILTC bed capacities increase in the foreseeable future, (34) the bed crunch situation in hospitals will be eased.…”

“…(6) Prolonged stay in acute hospitals increases the risk of hospital-acquired infections, and disrupts patient flow and access to care due to bed shortages. The hospital bed crunch problem raises concerns about patient safety and the adequacy of healthcare infrastructure.…”

Brazil is getting older: demographic changes and epidemiological challenges

“…However the estimated mean is that the health cost of supporting one elderly person could cover three people of another age group 59,78 . The United States have estimated that per capita costs of the elderly are about 3 times those of young peoples aged less than 15 years, which means more than $4,000 per years, per old person 5 , largely due to the fact that an elderly person is more likely to became sick and need costly medical treatment 8,36,64 . In Australia, government spending on the aged is 2.3 times greater than on the young 23 .…”

Predicting elderly patient length of stay in hospital and community care using a series of conditional Coxian phase-type distributions, further conditioned on a survival tree

“…The focus of the current research is to describe the movement of elderly patients through multiple ordered stages, from the initial hospital admission, to the first community stage, then the first hospital readmission stage, followed by the second community stage and finally the second hospital readmission stage. Nevertheless, due to the inherent variability in the time spent at each stage in the pathway for elderly patients, an approach which makes predictions based on the assumption that the elderly population is homogeneous with respect to length of stay, is often inaccurate [5]. Although length of stay may appear a simple metric, it can be influenced by a number of factors including reason for admission, hospital policy and issues extending beyond the hospital environment.…”