[Quantification of excessive length of hospital stay ('wrong bed problem'); hip fractures in the elderly].
OBJECTIVE
To assess the magnitude of hospital bed misoccupation by elderly patients admitted because of a hip fracture.


METHODS
Prospective clinical study.


METHODS
Department of surgery-traumatology of Leiden University Hospital, the Netherlands.


METHODS
All patients with a hip fracture admitted from January 1991 to April 1993 were registered for age, ability level, pre-existent disease, housing situation, social environment, morbidity, mortality and duration of hospital stay. The misexploitation of hospital beds was calculated based on an optimal hospital stay of 9 days. When complications occurred, necessitating longer medical treatment, this optimum was adjusted in each individual case.


RESULTS
The mean hospital stay in 123 patients who had to be transferred to a nursing home when they had previously lived in their own homes or in an old people's home was 23.8 days, and 11.6 days above the optimum; for patients who could return to their previous housing situation these figures were 13.5 and 4.2 respectively (p < or = 0.05). Age, ability level, pre-existent disease and less importantly the social environment influenced the possibilities for a patient to return to his/her own home. Use of a clinimetric scale, which objectively assessed the probability of resocialisation, decreased the mean hospital stay from 28-30 days to less than 17.


CONCLUSIONS
To minimize the duration of unnecessary hospital stay, use of a clinimetric scale on admission to assess the probability of rapid resocialisation can be useful.
van Vugt
A B
AB
Academisch Ziekenhuis, afd. Heelkunde-Traumatologie, Leiden.
Touw
C R
CR
D000368:Aged; D000369:Aged, 80 and over; D001509:Bed Occupancy; D015897:Comorbidity; D005260:Female; D006300:Health Services Misuse; D006620:Hip Fractures / Q000534:rehabilitation*; D006798:Housing; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010351:Patient Discharge; D010360:Patient Transfer; D011446:Prospective Studies; D012931:Social Environment
Kwantificering van te langdurige ziekenhuisopname ('verkeerde-beddenproblematiek'); heupfracturen bij bejaarden.