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Predictors of Community Discharge from a Geriatric Assessment and Rehabilitation Unit

Published online by Cambridge University Press:  29 November 2010

L. Pereles ,
J. Peitchinis ,
E. Jennings  and
T. Fung
L. Pereles
Affiliation:
Holy Cross Hospital
J. Peitchinis
Affiliation:
Holy Cross Hospital
E. Jennings
Affiliation:
Holy Cross Hospital
T. Fung
Affiliation:
Holy Cross Hospital
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Abstract

This study explored admission factors which predicted the successful return to the community of patients entering a Geriatric Assessment and Rehabilitation Program (GARP). A stepwise logistic regression technique was used to determine predictive factors from a consecutive sample of 100 medical or surgical geriatric patients admitted for a four to six week rehabilitation program. The significant independent predictors of discharge which could be determined at the time of admission were ability to safely medicate, admission from the community, GDS score and the number of supports. The ability to safely medicate may be an important but under-utilized predictor.

Résumé

Cette étude examine les facteurs d'admission pouvant déterminer la réinsertion dans la communauté de patients ayant été admis au programme gériatrique d'évaluation et de rééducation (GARP). La régression logistique à inclusion hiérarchique a été utilisée afin de déterminer les facteurs de prédiction au sein d'un échantillon consécutif de 100 personnes, nécessitant des soins médicaux ou chirurgicaux en gériatrie, admises à un programme de rééducation de quatre à six semaines. Les principaux prédicteurs indépendants établissant le congé et pouvant être déterminés dès l'admission étaient: la possibilité de prescrire sans danger des médicaments, l'admission d'une personne provenant de la communauté, la valeur «GDS» et le soutien social. La possibilité de prescrire sans danger des médicaments peut constituer un prédicteur important, quoi qu'il ne soit pas souvent utilisé.

Keywords

Community DischargeGeriatric Assessment Rehabilitation.Congéévaluation gériatrique de rééducation.
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 13 , Issue 1 , Printemps/Spring 1994 , pp. 41 - 50
Copyright
Copyright © Canadian Association on Gerontology 1994

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References

1.Epstein, AM, Hall, JA, Besdine, R, Cumella, E Jr, Feldstein, M, McNeil, B et al. The emergence of geriatric assessment units the “new technology of geriatrics”. Annual of Internal Medicine 1987; 106: 299–303.CrossRefGoogle Scholar
2.Rubenstein, LZ, Josephson, KR, Wieland, GD, English, MS, Sayre, JA, Kane, RL. Effectiveness of a geriatric evaluation unit: A randomized clinical trial. New England Journal of Medicine 1984; 311(26): 1664–7.CrossRefGoogle ScholarPubMed
3.Rubenstein, LZ, Wieland, D, English, P, Josephson, K, Sayre, JS, Abrass, IB. The Sepulveda VA geriatric evaluation unit: Data on four-year outcomes and predictors of improved outcomes. The Journal of the American Geriatric Society 1984; 32(7): 503–12.CrossRefGoogle Scholar
4.Liem, PH, Chernoff, R, Carter, WJ. Geriatric rehabilitation unit: A 3-year outcome evaluation. Journal of Gerontology 1986; 41(4): 44–50.CrossRefGoogle ScholarPubMed
5.Applegate, WB, Akins, D, Zwagg, RV, Thoni, K, Baker, MG. The geriatric rehabilitation and assessment unit in a community hospital. The Journal of the American Geriatric Society 1983; 31(4): 206–10.CrossRefGoogle Scholar
6.Applegate, WB, Miller, ST, Graney, MJ, Elam, JT, Burns, R, Akins, DE. A randomized, controlled trial of a geriatric assessment unit in a community rehabilitation hospital. New England Journal of Medicine 1990 May 31; 322(22): 1572–8.CrossRefGoogle Scholar
7.Cohen, L. Ottawa's geriatric assessment program “Better care is less expensive”. Canadian Medical Association Journal 1989 March 15; 140: 710–3.Google Scholar
8.Fretwell, MD, Raymond, PM, McGarvey, ST, Owens, N, Traines, M, Silliman, RA et al. The senior care study: A controlled trial of a consultative/unit based geriatrie assessment program in acute care. The Journal of the American Geriatrie Society 1990; 38: 1073–81.CrossRefGoogle Scholar
9.Rubenstein, LZ, Wieland, GD, Josephson, KR, Rosebrook, B, Sayre, J, Kane, RL. Improved survival for frail elderly inpatients on geriatric evaluation unit (GEU): Who benefits? Improved survival for frail elderly inpatients on geriatric evaluation unit (GEU): Who benefits 1988; 41(5): 441–9.Google ScholarPubMed
10.Sloane, P. Nursing home candidates: Hospital inpatient trial to identify those appropriately assignable to less intensive care. The Journal of the American Geriatric Society 1980; 28: 11.CrossRefGoogle ScholarPubMed
11.Katz, S, Akpom, A. A measure of primary sociobiological functions. International Journal of Health Services 1976; 6(3): 493–507.CrossRefGoogle ScholarPubMed
12.Yesavage, JA, Brink, TL, Rose, TL, Lum, O, Huang, V, Adey, M et al. Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research 1983; 17(1): 37–49.CrossRefGoogle Scholar
13.Folstein, MF, Folstein, SE, McHugh, PR. “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 1975; 12: 189–98.CrossRefGoogle ScholarPubMed
14.Romanko, L, Pereles, L. An evaluation of a pharmacy assessment for geriatric patients. Canadian Journal of Hospital Pharmacy 1992; 45(1): 15–20.Google Scholar
15.Engelman, L. Stepwise logistic regression by maximum likelihood or asymptotic covariance. BMDP Statisical Software 1980; Technical Report #74.Google Scholar
16.Smith, A, Slaughter, SE, Berg, K. Evaluation of a geriatric rehabilitation unit. Gerontology 1987 Fall; 15–17.Google ScholarPubMed
17.Narain, P, Rubenstein, LZ, Weiland, GD, Rosebrook, B, Strome, LS, Pietruszka, PA. Predictors of immediate and 6-month outcomes in hospitalized elderly patients. The Journal of the American Geriatric Society 1988; 37: 775–83.CrossRefGoogle Scholar
18.Clarfield, AM. The reversible dementias: Do they reverse? The reversible dementias: Do they reverse 1988; 476–86.Google ScholarPubMed
19.McCusker, J, Mundt, DJ, Stoddard, AM, Cole, E, Whitbourne, SK, Simmons, JE. Outcomes of a geriatric rehabilitation program in a long-term care facility. The Journal Aging and Health 1989 Nov; 485–506.CrossRefGoogle ScholarPubMed
20.Wachtel, TM, Derby, C, Fulton, JP. Predicting the outcome of hospitalization for elderly persons: Home versus nursing home. Southern Medical Journal 1984; 77(10): 1283–5.CrossRefGoogle ScholarPubMed
21.Myers, JK, Wiessman, MM, Tischler, GL, Holzer, CE III, Leaf, PJ, Orvaschel, H et al. Six-month prevalence of psychiatric disorders in three communities. Archives of General Psychiatry, 1984 Oct; Vol 41.CrossRefGoogle ScholarPubMed
22.Wachtel, TM, Fulton, JP, Goldfarb, J. Early prediction of discharge disposition after hospitalization. The Gerontologist 1987; 27(1): 98–103.CrossRefGoogle ScholarPubMed
23.Hood, JC, Murphy, JE. Patient noncompliance can lead to hospital readmissions. Hospitals 1978; 52: 79–84.Google ScholarPubMed
24.Beers, M, Ouslander, J. Risk factors in geriatric drug prescribing: A practical guide to avoiding problems. Drugs 1989; 37: 105–12.CrossRefGoogle ScholarPubMed