Login to MyKarger

New to MyKarger? Click here to sign up.



Login with Facebook

Forgot your password?

Authors, Editors, Reviewers

For Manuscript Submission, Check or Review Login please go to Submission Websites List.

Submission Websites List

Institutional Login
(Shibboleth or Open Athens)

For the academic login, please select your country in the dropdown list. You will be redirected to verify your credentials.

Clinical Section

Use of In-Patient Hospital Beds by People Living in Residential Care

Finucane P. · Wundke R. · Whitehead C. · Williamson L. · Baggoley C.

Author affiliations

Flinders Medical Centre and Flinders University of South Australia, Bedford Park, Adelaide, SA, Australia

Related Articles for ""

Gerontology 2000;46:133–138

Do you have an account?

Login Information





Contact Information











I have read the Karger Terms and Conditions and agree.



Login Information





Contact Information











I have read the Karger Terms and Conditions and agree.



To view the fulltext, please log in

To view the pdf, please log in

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.


Save over 20% compared to the individual article price.
Learn more

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restrictions apply

Rental: USD 8.50
Cloud: USD 20.00


Select

Subscribe

  • Access to all articles of the subscribed year(s) guaranteed for 5 years
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview
Abstract of Clinical Section

Published online: April 13, 2000
Issue release date: May – June

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 2

ISSN: 0304-324X (Print)
eISSN: 1423-0003 (Online)

For additional information: https://www.karger.com/GER

Abstract

Background: There is concern that people living in residential care in Australia make significant and often inappropriate use of acute in-patient hospital services. To date, no factual information has been collected in Australia and its absence may allow myths and negative stereotypes to proliferate. Objective: To determine how and why people living in residential care in Australia use in-patient hospital beds. To determine the outcome of hospitalisation and functional status at 3 months following discharge. Methods: Prospective study of 184 consecutive admissions to hospital following Emergency Department (ED) attendance involving people aged over 65 years and living in residential care in southern Adelaide, South Australia. Information was obtained from the facilities’ transfer letters, and where these were inadequate or absent, telephone interviews were held with residential care staff. Results: 153 people accounted for the 184 admissions. They had a mean age of 84 years and 69% were female. 61% came from hostels and 35% from nursing homes. They had a wide range of clinical problems and twice as many were admitted to medical than to surgical units. Their mean length of hospital stay was 7.9 days, 2.3 days higher than for non-same-day patients and was higher for hostel than for nursing home residents. All but two admissions were considered unavoidable though the provision of specialised care within residential care could have prevented a further 19 (10%) admissions. 96% of admissions resulted in survival to leave hospital and in 74%, people returned directly to their place of origin. At 3 months follow-up, a further 20% of the group had died while 5% were in hospital. In all, 14% of the original group were in a different long-term care facility while 56% were living at their former residence. Conclusions: People living in residential care are often hospitalised because of acute illness. In the vast majority of cases hospitalisation is both appropriate and unavoidable. Most did not require prolonged hospitalisation and were discharged alive, usually to their original residence. However, within 3 months many had died or had functionally declined. Strategies that prevent health breakdown in the residential care setting need to be developed and trialed.

© 2000 S. Karger AG, Basel


References

  1. Helme RD: Making the health care system work for older people. Med J Aust 1997;167:403–404.
  2. Australian Institute of Health and Welfare: Australia’s Welfare: Services and Assistance. Canberra, AGPS, 1995.
  3. Stark AJ, Gutman GM, McCashin B: Acute-care hospitalisations and long-term care: an examination of transfers. J Am Geriatr Soc 1982;30:509–515.
    External Resources
  4. Tresch DD, Simpson WM, Burton JR: Relationship of long-term and acute-care facilities. J Am Geriatr Soc 1985;33:819–826.
    External Resources
  5. Rubenstein LZ, Ouslander JG, Wieland D: Dynamics and clinical implications of the nursing home-hospital interface. Clin Geriatr Med 1988;4:471–491.
  6. Bergman H, Clarfield AM: Appropriateness of patient transfer from a nursing home to an acute-care hospital: A study of emergency room visits and hospital admissions. J Am Geriatr Soc 1991;39:1164–1168.
  7. Creditor MC: Hazards of hospitalisation of the elderly. Ann Intern Med 1993;118:219–223.
  8. Sager MA, Rudberg MA, Jalaluddin M, Franke T, Inouye SK, Landefeld CS, Siebens H, Winograd CH: Hospital admission risk profile (HARP): Identifying older patients at risk for functional decline following acute medical illness and hospitalization. J Am Geriatr Soc 1996;44:251–257.
  9. Zimmer JG, Eggert GM, Treat A, Brodows B: Nursing homes as acute care providers: A pilot study of incentives to reduce hospitalizations. J Am Geriatr Soc 1988;36:124–129.
    External Resources
  10. Mehr DR: Nursing-home-acquired pneumonia: How and where to treat? J Am Board Fam Pract 1997;10:168–170.
  11. Kayser-Jones JS, Wiener CL, Barbaccia JC: Factors contributing to the hospitalization of nursing home residents. Gerontologist 1989;29:502–510.
    External Resources
  12. Wieland D, Rubenstein LZ, Ouslander JG: Organising an academic nursing home. JAMA 1986;255:2622–2627.
  13. Kerr HD, Byrd JC: Nursing home patients transferred by ambulance to a VA emergency department. J Am Geriatr Soc 1991;39:132–136.
  14. Murphy FW: Blocked beds. Br Med J 1977;i:1395–1396.
  15. Gordon M, Klapecki KC, Wilson DB: Emergency care and the patient in the long-term care facility. Can Med Assoc J 1991;145:19–21.
  16. Shem S: The House of God. London, Bodley Head, 1978.
  17. Callahan D: Controlling the costs of health care for the elderly – fair means and foul. N Engl J Med 1996;335:744–746.
  18. Finucane PM, Wundke R, Whitehead C, Williamson L, Baggoley CJ: Profile of people referred to an emergency department from residential care. Aust NZ J Med 1999;29:494–499.
  19. Australian Bureau of Statistics (ABS) 1996: Projections of the populations of Australia States and Territories, 1995-2051, Catalogue No. 3222.0, ABS, Canberra.
  20. Mahoney FI, Barthel DW: Functional evaluation: the Barthel index. Md State Med J 1965;14:61–65.
    External Resources
  21. Baggoley CJ, Phillips DG, Aplin PJ: A study of emergency admissions at the Flinders Medical Centre using the Appropriateness Evaluation Protocol. Emerg Med 1994;6:29–36.
  22. Norusis MJ: SPSS for Windows: Base system user’s guide, release 6.0. Chicago, SPSS, 1993.
  23. Barker WH, Zimmer JG, Hall J, Ruff BC, Freundlich CB, Eggert GM: Rates, patterns, causes and costs of hospitalization of nursing home residents: a population-based study. Am J Publ Health 1994;84:1615–1620.
  24. Lewis MA, Cretin S, Kane RL: The natural history of nursing home patients. Gerontologist 1985;25:382–388.
    External Resources
  25. Smith WR, Kellerman A, Brown JS: The impact of nursing home transfer policies at the end of life in a public acute care hospital. J Am Geriatr Soc 1995;43:1052–1057.
  26. Conard AF: Elder choice. Am J Law Med 1993;19:233–283.

Article / Publication Details

First-Page Preview
Abstract of Clinical Section

Published online: April 13, 2000
Issue release date: May – June

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 2

ISSN: 0304-324X (Print)
eISSN: 1423-0003 (Online)

For additional information: https://www.karger.com/GER


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.