title: Patient outcomes after discharge from a geriatric day hospital.
abstract: Evidence suggests that frailer older patients benefit from a continuum of care rather than the admit/discharge model of our health system. This study examined patient outcomes after discharge from a geriatric day hospital (GDH) to determine what proportion continues to do well, what proportion declines, how the two groups differ, and if factors predictive of deterioration can be identified. Using telephone survey and Goal Attainment Scaling methodologies, the goals of 151 patients discharged from a GDH between 6 and 18 months previously were examined to determine whether GDH achievements were maintained or lost. All but 5 patients improved between GDH admission and discharge; after discharge, 39 per cent deteriorated. The need for more support in the community was predictive of deterioration, probably reflecting patient frailty. Number of medical diagnoses or medications were not predictive. Frailer older patients tend not to maintain goals achieved in a GDH after discharge and may benefit from ongoing maintenance.
authors.affiliation: Division of Geriatric Medicine, St. Joseph's Health Care London - Parkwood Site, 801 Commissioners Road East, London, ON, N6C 5J1, Canada. rcrilly@uwo.ca
authors.forename: Richard G
authors.initials: RG
authors.lastname: Crilly
authors.forename: Sonya
authors.initials: S
authors.lastname: Lytwynec
authors.forename: Marita
authors.initials: M
authors.lastname: Kloseck
authors.forename: Jan M
authors.initials: JM
authors.lastname: Smith
authors.forename: Tyler
authors.initials: T
authors.lastname: Olsen
authors.forename: Bill
authors.initials: B
authors.lastname: Gold
authors.forename: Shelley
authors.initials: S
authors.lastname: Masse
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D002170:Canada; D017028:Caregivers; D003266:Continuity of Patient Care; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D012656:Self-Help Devices; D011795:Surveys and Questionnaires