[Investigation on the identification and care of geriatric patients in regular hospitals for acute cases with respect to DRGs].
The aim of this pilot project, carried out over a period of 4 weeks, was to identify geriatric patients, hospitalised because of acute illness in the state of Baden-Wurttemberg, by means of a data entry form. A preliminary survey was expected to show the extent of medical care of acutely hospitalised geriatric patients in this state with special reference to the DRG system introduced recently. In addition, a questionnaire was used to check on acceptance and practicability of the evaluation process for adequate geriatric medical care. 985 patients hospitalised in 13 departments of 11 hospitals were included in the project. Of these, 352 were classified as "geriatric patients" according to the criteria "age usually > 65 years", "multimorbidity" and "disabilities in every day life". Without a major breach of protocol the data of 5 departments could be evaluated, representing 624 patients with 490 patients giving informed consent to participate in the project. Of these, 248 (39.7%) fulfilled the criteria for geriatric patients. Results show that approximately half of these patients require specific geriatric care, such as geriatric counselling, complex geriatric treatment and geriatric rehabilitation. In hospitals with specific geriatric competence, the need for geriatric care was higher than in those without. However, because of structural deficits, hospitals were unable to meet all these needs. The data entry form, in general, was accepted by the majority of the participants and proved to be practicable. Its use was more advantageous (optimisation of geriatric care) than disadvantageous (additional documentation). Data analysis suggests a reduction of the criteria for identification of geriatric patients to 2: "age" and "complex characteristics of geriatric multimorbidity".
Heiss
H W
HW
Zentrum für Geriatrie und Gerontologie Freiburg, Universitätsklinikum, Freiburg i. Br., Germany. wolfgang.heiss@uniklinik-freiburg.de
D000208:Acute Disease / Q000145:classification* / Q000453:epidemiology*; D000368:Aged; D000369:Aged, 80 and over; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized