Outcomes of hospital care in aged residents

Mudge, A., Denaro, C. and O'Rouke, P. (2010). Outcomes of hospital care in aged residents. In: Abstracts for the World Congress of Internal Medicine, World Congress of Internal Medicine in Conjunction with Physicians Week. World Congress in Internal Medicine, Melbourne, VIC, Australia, (39-39). 20 – 25 March 2010. doi:10.1111/j.1445-5994.2010.02186.x


Author Mudge, A.
Denaro, C.
O'Rouke, P.
Title of paper Outcomes of hospital care in aged residents
Conference name World Congress in Internal Medicine
Conference location Melbourne, VIC, Australia
Conference dates 20 – 25 March 2010
Proceedings title Abstracts for the World Congress of Internal Medicine, World Congress of Internal Medicine in Conjunction with Physicians Week   Check publisher's open access policy
Journal name International Journal of Medicine   Check publisher's open access policy
Place of Publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Publication Year 2010
Sub-type Oral presentation
DOI 10.1111/j.1445-5994.2010.02186.x
ISSN 1445-5994
1444-0903
Volume 40
Issue Sp. 1
Start page 39
End page 39
Total pages 1
Language eng
Formatted Abstract/Summary
Introduction: Residential aged care (RAC) is a significant source of referral for hospital inpatient care. RAC patients are older and frailer than community-living patients, but have often been excluded from models of ‘acute care for elders’. There are few published studies describing the hospital outcomes of patients admitted from RAC.

Aims: To describe the characteristics and outcomes of older medical patients admitted to a general medical service from RAC; compare these with older medical patients referred from the community; and examine to the impact of an interdisciplinary care model on outcomes in this subgroup.

Methods:
Pre-planned subgroup analysis of a large pseudo-randomised trial of interdisciplinary care conducted in a tertiary teaching hospital in Brisbane, Australia. Patients were allocated to either usual care (n = 491) or a care model including increased allied health staffing, consistent interdisciplinary teams, regular communication and discharge planning (n = 513). Characteristics and hospital outcomes of patients aged 65 or older referred from RAC were compared with patients aged 65 or older referred from the community. Analysis of the impact of the new model of care on hospital utilisation, mortality, functional outcomes and readmission was stratified according to previous residence.

Results: Patients from RAC (n = 189) were older, with greater functional and cognitive impairment, than community-living patients (n = 815). They had similar length of stay, but much higher in-hospital mortality (13 vs. 6%, p = 0.001) and 6 month mortality (35% vs. 17%, p = 0.001). The intervention produced a marked reduction in in-hospital mortality in the RAC subgroup (5% vs. 22%, P < 0.001)) which was sustained at 6 months (28% vs. 44%, p = 0.02), although this was associated with a trend to more hospital readmissions over 6 months (33% vs. 22%, p = 0.15).

Conclusion: This subgroup analysis suggests that the poor outcomes of hospitalisation seen in RAC patients can be ameliorated by changes in the model of care.
Q-Index Code EX
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Conference Paper
Collection: School of Medicine Publications
 
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Created: Wed, 23 Feb 2011, 11:01:03 EST by Amarjeet Sanghera on behalf of Medicine - Royal Brisbane and Women's Hospital