Social admissions of the elderly: More medical attention should be paid

Chou, Ming Yueh; Chen, Liang Kung

doi:10.1016/j.jcgg.2010.11.001

Cited by 6 publications

(5 citation statements)

References 19 publications

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“…Traditional predictors of clinical instability including body temperature, blood pressure, heart rate and oxygenation desaturation have been reported to be associated with rehabilitation outcome, but little is known regarding functional measurements in relation to clinical instability in PAC units. Comprehensive geriatric assessment (CGA) is a multidimensional interdisciplinary tool used to detect geriatric problems, which can discover medical, psychological, and functional needs and deficits, and has been widely used in geriatric studies . Previous studies evaluating acute ward readmissions were focused on administrative levels, such as drug adverse effect monitoring, coordination and post‐discharge communication .…”

Section: Introductionmentioning

confidence: 99%

“…Comprehensive geriatric assessment (CGA) is a multidimensional interdisciplinary tool used to detect geriatric problems, 13,14 which can discover medical, psychological, and functional needs and deficits, and has been widely used in geriatric studies. 15,16 Previous studies evaluating acute ward readmissions were focused on administrative levels, such as drug adverse effect monitoring, coordination and post-discharge communication. [17][18][19][20][21] Therefore, the main purpose of the present study was to explore the predictive factors for clinical instability among older patients admitted to PAC units in Taiwan to improve the quality of PAC services.…”

Section: Introductionmentioning

confidence: 99%

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Predicting clinical instability of older patients in post‐acute care units: A nationwide cohort study

Lee

Chou²,

Peng

et al. 2013

Geriatrics Gerontology Int

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predicting clinical instability of older patients in post‐acute care units: A nationwide cohort study

Lee

Chou²,

Peng

et al. 2013

Geriatrics Gerontology Int

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“…Another study also observed that, most patients initially labeled as “Failure to thrive” were eventually diagnosed with an acute condition, with more than a third receiving antibiotics [ 24 ]. Similarly, mortality in patients labeled as “Social admission” has been found significantly higher than mortality of elderly patients admitted because of specific acute illnesses [ 25 ]. Finally, another study showed that 85% of frail elderly patients initially labeled as “Lack of community support” after initial ED examination were eventually identified with significant medical conditions [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Differences in triage category, priority level and hospitalization rate between young-old and old-old patients visiting the emergency department

Vilpert

Monod²,

Ruedin³

et al. 2018

BMC Health Serv Res

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BackgroundEmergency Department (ED) are challenged by the increasing number of visits made by the heterogeneous population of elderly persons. This study aims to 1) compare chief complaints (triage categories) and level of priority; 2) to investigate their association with hospitalization after an ED visit; 3) to explore factors explaining the difference in hospitalization rates among community-dwelling older adults aged 65–84 vs 85+ years.MethodsAll ED visits of patients age 65 and over that occurred between 2005 and 2010 to the University of Lausanne Medical Center were analyzed. Associations of hospitalization with triage categories and level of priority using regressions were compared between the two age groups. Blinder-Oaxaca decomposition was performed to explore how much age-related differences in prevalence of priority level and triage categories contributed to predicted difference in hospitalization rates across the two age groups.ResultsAmong 39′178 ED visits, 8′812 (22.5%) occurred in 85+ patients. This group had fewer high priority and more low priority conditions than the younger group. Older patients were more frequently triaged in “Trauma” (20.9 vs 15.0%) and “Home care impossible” (10.1% vs 4.2%) categories, and were more frequently hospitalized after their ED visit (69.1% vs 58.5%). Differences in prevalence of triage categories between the two age groups explained a quarter (26%) of the total age-related difference in hospitalization rates, whereas priority level did not play a role.ConclusionsPrevalence of priority level and in triage categories differed across the two age groups but only triage categories contributed moderately to explaining the age-related difference in hospitalization rates after the ED visit. Indeed, most of this difference remained unexplained, suggesting that age itself, besides other unmeasured factors, may play a role in explaining the higher hospitalization rate in patients aged 85+ years.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3257-9) contains supplementary material, which is available to authorized users.

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“…Careful management of physical health and functional status is needed because a history of hospitalization in the older adults leads to repeated readmission, admission to a long-term care facility, and death, and hospitalization in a medical institution means deterioration of physical health and functional status [3,4]. Social hospitalization, a major cause of increased medical expenses for older adults, can be defined as a phenomenon in which the need for hospitalization is clinically low, but inappropriate-, prolonged hospitalization due to personal or socioeconomic conditions occurs [5,6,7,8]. According to research conducted in Korea, 74% of inpatients in long-term care hospitals were hospitalized by their families, not by themselves, and 6.1% of inpatients were physically impaired with low medical needs [9].…”

Section: Introductionmentioning

confidence: 99%

Impact of a Pilot Project for Integrated Care on Hospitalization Rate among Older Adults in South Korea

Choi,

Bang,

Yoo

et al. 2024

Int J Integr Care

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Introduction: Since 2019, the Korean government has implemented a pilot project for integrated care to encourage healthy aging of older adults. This study investigated the changes in hospitalization rates among older adults who participated in the integrated care pilot project. Methods: Administrative survey data collected from 13 local governments and the National Health Insurance Database were used in present study. The participants comprised 17,801 older adults who participated in the pilot project between August 01, 2019 and April 30, 2022 and 68,145 matched controls. A propensity score matching method was employed to select the control group, and this study employed difference-in-differences (DID) approach to examine variations in the hospitalization rate. Results: The DID analysis revealed that the odds ratio for rates of hospitalization among older adults who participated in the pilot project was 0.88 (95% confidence interval [CI] 0.84, 0.91) in comparison to control group. In specifically, as compared to the control group, the odds ratio for hospitalization rates among the pilot project’s discharged patients was 0.17 (95% CI 0.15, 0.20). Although not statistically significant, the odds ratio of older adults who utilized LTCI services was 0.93 (95% CI 0.83, 1.05), and the odds ratio of older adults who applied for LTCI but were rejected or were intensive social care was 1.09 (95% CI 0.95, 1.26) compared to the comparison group. Discussion: The findings imply that the discharged patient group had greater medical demands than the other types, and it can be claimed that this is the group that may anticipate greater efficacy while using health services. In addition, the integrated care services provided by the pilot project have the effect of reducing unnecessary hospitalization such as social hospitalization. Conclusion: Participants in the integrated care pilot project showed a lower hospitalization rate than the older adults who did not participate in the project but had similar characteristics. In particular, the admission rate of discharged patients showed a sharp decline.

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Social admissions of the elderly: More medical attention should be paid

Cited by 6 publications

References 19 publications

Predicting clinical instability of older patients in post‐acute care units: A nationwide cohort study

Predicting clinical instability of older patients in post‐acute care units: A nationwide cohort study

Differences in triage category, priority level and hospitalization rate between young-old and old-old patients visiting the emergency department

Impact of a Pilot Project for Integrated Care on Hospitalization Rate among Older Adults in South Korea

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