دورية أكاديمية
Incidence and risk factors for unplanned transfers to acute general hospitals from an intermediate care and rehabilitation geriatric facility.
| العنوان: | Incidence and risk factors for unplanned transfers to acute general hospitals from an intermediate care and rehabilitation geriatric facility. |
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| المؤلفون: | Colprim D; Parc Sanitari Pere Virgili, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: danicolprim@outlook.com., Inzitari M; Parc Sanitari Pere Virgili, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain. |
| المصدر: | Journal of the American Medical Directors Association [J Am Med Dir Assoc] 2014 Sep; Vol. 15 (9), pp. 687.e1-4. Date of Electronic Publication: 2014 Jul 30. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 100893243 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1538-9375 (Electronic) Linking ISSN: 15258610 NLM ISO Abbreviation: J Am Med Dir Assoc Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2005- : [New York?] : Elsevier Original Publication: Hagerstown, MD : Lippincott Williams & Wilkins, c2000- |
| مواضيع طبية MeSH: | Rehabilitation Centers*, Hospitalization/*statistics & numerical data , Hospitals, General/*statistics & numerical data , Patient Transfer/*statistics & numerical data, Aged ; Aged, 80 and over ; Female ; Geriatric Assessment ; Humans ; Incidence ; Male ; Prospective Studies ; Risk Factors |
| مستخلص: | Objective: Unplanned acute hospital transfers (AT) from post-acute or long-term care facilities represent critical transitions, which expose patients to negative health outcomes and increase the burden of the emergency departments that receive these patients. We aim at determining incidence and risk factors for AT during the first 30 days of admission at an intermediate care and rehabilitation geriatric facility (ICGF). Design and Setting: Prospective cohort study conducted in an ICGF of Barcelona, Spain. Sociodemographics, main diagnostics, and variables of the comprehensive geriatric assessment were recorded at admission. At the moment of AT, suspected diagnostic motivating the transfer was recorded. Multivariable Cox proportional hazard models were used to evaluate the association between admission characteristics and AT. Results: We included 1505 patients (mean age + standard deviation = 81.31 ± 7.06, 65.7% women). AT were 217 (14.4%, 5.64/1000 days of stay) resulting in only 81 final hospitalizations (37% of AT), whereas 136 patients returned to ICGF after visiting the emergency department. Principal triggers of AT were cardiovascular, falls/orthopedic, and gastrointestinal problems. Being admitted to ICGF after a general surgery [hazard ratio (HR) 1.88; 95% confidence interval (CI) 1.21-2.94; P < .001], taking 8 or more drugs at admission (HR 1.98; 95% CI 1.37-2.86; P < .001) and living with a partner (HR 1.35; 95% CI 1.01-1.81; P = .05) were independently associated with a higher risk of AT. Conclusions: In our sample, clinical and social characteristics at admission to an ICGF are associated with a higher risk of AT. A relevant proportion of AT is not admitted to the acute hospital, suggesting perhaps some avoidable AT. Identification of risk factors might be relevant to design strategies to reduce AT. (Copyright © 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Risk factors; acute hospital transfers; intermediate care facilities; rehospitalization |
| تواريخ الأحداث: | Date Created: 20140804 Date Completed: 20150512 Latest Revision: 20181202 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1016/j.jamda.2014.06.004 |
| PMID: | 25086689 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1538-9375 |
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| DOI: | 10.1016/j.jamda.2014.06.004 |