Prolonged stays in hospital acute geriatric care units: identification and analysis of causes.
In France, the population of very old frail patients, who require appropriate high-quality care, is increasing. Given the current economic climate, the mean duration of hospitalization (MDH) needs to be optimized. This prospective study analyzed the causes of prolonged hospitalization in an acute geriatric care unit. Over 6 months, all patients admitted to the target acute geriatric care unit were included and distributed into two groups according to a threshold stay of 14 days: long MDH group (LMDHG) and short MDH group (SMDHG). These two groups were compared. 757 patients were included. The LMDHG comprised 442 with a mean age of 86.7 years, of whom 67.65% were women and the SMDHG comprised 315 with a mean age of 86.6 years, of whom 63.2% were women. The two groups were statistically similar for age, sex, living conditions at home (alone or not, help), medical history and number of drugs. Patients in the LMDHG were more dependent (p=0.005), and were more likely to be hospitalized for social reasons (p=0.024) and to have come from their homes (p=0.011) than those in the SMDHG. The reasons for the prolonged stay, more frequent in the LMDHG than the SMDHG (p<0.05), were principally: waiting for imaging examinations, medical complications, and waiting for discharge solutions, assistance from social workers and/or specialist consultations. In order to reduce the MDH in acute geriatric care unit, it is necessary to consider the particularities of the patients who are admitted, their medico-socio-psychological management, access to technical facilities/consultations and post-discharge accommodation.
Service de médecine interne et gériatrie, Hôpital de Champmaillot CHU, Dijon, France.
Vivien
V
Parent
Service de médecine interne et gériatrie, Hôpital de Champmaillot CHU, Dijon, France.
Stéphanie
S
Ludwig-Béal
Service de médecine interne et gériatrie, Hôpital de Champmaillot CHU, Dijon, France.
Hélène
H
Sordet-Guépet
Service de médecine interne et gériatrie, Hôpital de Champmaillot CHU, Dijon, France.
Laura
L
Popitéan
Service de médecine interne et gériatrie, Hôpital de Champmaillot CHU, Dijon, France.
Agnès
A
Camus
Service de médecine interne et gériatrie, Hôpital de Champmaillot CHU, Dijon, France.
Sofia
S
Da Silva
Service de médecine interne et gériatrie, Hôpital de Champmaillot CHU, Dijon, France.
Anne
A
Lubrano
Service de médecine interne et gériatrie, Hôpital de Champmaillot CHU, Dijon, France.
Frederick
F
Laissus
Ehpad, Hôpital de Champmaillot CHU, Dijon, France.
Laurence
L
Vaillard
Service de médecine interne et gériatrie, Hôpital de Champmaillot CHU, Dijon, France, Inserm U1093 : cognition, action, et plasticité sensorimotrice (CAPS), Université de Bourgogne Franche Comté, Dijon, France.
Patrick
P
Manckoundia
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France; D005853:Geriatrics; D006757:Hospital Units / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome
acute geriatrics; elderly people; geriatric care; mean duration of hospitalization