[Geriatric home visits can prevent hospitalisation of subacute patients but is time-consuming. A randomised study].
OBJECTIVE
To study if geriatric home visits could prevent hospital admittance of geriatric patients referred subacute by general practitioners.


METHODS
Patients were randomised to first contact by geriatric home visit (n=59), or to subacute admittance to a geriatric ward (n=43), median age 79.0 and 82.5 years, women 64% and 72%, Barthel-index 755 and 770 and MMSE 24,0 and 23,0. Only 30% of the total number of subacute referred patients were included.


RESULTS
53% (31/59) randomised to home visits were not admitted to hospital, 17% (10/59) were admitted at the first home visit and 12% (7/59) within the first 7 days. Patients admitted within the first 7 days were more often single, 84% (n=16/19) as compared to 52% (16/31) of those not admitted. The time used on home visits was on average 122 min, including 23 min (19%) for transportation. Among the 43 patients randomised to subacute admittance 16% (7/43) were sent home within 24 hours, and of these 73% were seen in the outpatient clinic, 26% (11/42) were sent home on day 2-7 and of these 27% were seen in the outpatient clinic. The overall median time in contact with the geriatric department was 27.1 days (n=59) in the home visit group and 15.0 days (n=43) in the admitted group (p<0.05). There were no significant differences in patient satisfaction or self-rated health. The average time used by the municipality for home service was reduced to 15 min/day in patients sent to hospital (p<0.01) and increased to 44 min/day in patients not admitted (p<0.05).


CONCLUSIONS
Hospital admittance was avoided by geriatric home visits. However, time consumption was high. The municipality costs increased for non-admitted patients. The overall time in contact with the geriatric department was shortest for admitted patients.
Matzen
Lars Erik
LE
Odense Universitetshospital, Geriatrisk Afdeling G, Odense C. lars.matzen@ouh.fyns-amt.dk
Foged
Laila
L
Pedersen
Palle
P
Wengle
Kirsten
K
Andersen-Ranberg
Karen
K
D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark; D005260:Female; D015577:Geriatric Assessment; D005851:Geriatric Nursing; D006699:Home Care Services; D006792:House Calls; D006801:Humans; D008297:Male; D010348:Patient Care Team; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D013996:Time and Motion Studies; D000078329:Workforce