[Short-term care after hospitalization: influencing factors for discharge to the patient's own home environment].
A special short-term care (KZP) in a nursing home is offered to patients who are not yet able to live independently after hospitalization. It was institutionalized in 1989. But its basic conditions changed in 1996 with the new Pflegeversicherungsgesetz (nursing insurance law): the maximal stay was limited to 4 weeks and cost were turned over to the new insurance system. The paper analyzes the part KZP plays in health care maintenance. It addresses the questions which kind of patients is referred to KZP and what factors influence discharge at home vs admission to end-term nursing homes.A total of 325 patient's records (female: 80.3%) from 5 KZP institutions in the city of Bremen were analyzed (nearly 50% of all clients, who were formerly hospitalized). Patient's mean age was 82.9 years. Hospitalization lasted three weeks with men staying 27.6 days and women staying 20.1 days. Nervous disorders (especially apoplexy) and cardiovascular diseases are very common. After the stay in KZP, 39.1% moved to nursing homes, 36.0% returned home. Predictors for nursing home admission are long-lasting hospitalization, predicted need of long-term care by physicians, and nervous disorders. The results show that short-term care is a useful concept in health care maintenance of patients with special diseases und complicates re-convalescence.
Kolip
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Universität Bremen-Fachbereich 11, Zentrum für Public Health, 28334 Bremen, Germany. kolip@bips.uni-bremen.de
Güse
H-G
HG
D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006699:Home Care Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D017678:Sex Distribution; D013727:Terminal Care / Q000706:statistics & numerical data*