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Use of Acute Care Hospitals by Long-Stay Patients: Who, How Much, and Why?

Published online by Cambridge University Press:  31 March 2010

Carolyn De Coster*
Affiliation:
Department of Community Health Sciences, University of Manitoba
Sharon Bruce
Affiliation:
Department of Community Health Sciences, University of Manitoba
Anita Kozyrskyi
Affiliation:
Department of Community Health Sciences, University of Manitoba
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être addressées à : Carolyn De Coster, Ph.D., R.N., Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, 727 McDermot Avenue, Suite 408, Winnipeg, MB R3E 3P5. (Carolyn_DeCoster@cpe.umanitoba.ca)

Abstract

The effects of long-term hospitalizations can be severe, especially among older adults. In Manitoba, between fiscal years 1991/1992 and 1999/2000, 40 per cent of acute care hospital days were used by the 5 per cent of patients who had long stays, defined as stays of more than 30 days. These proportions were remarkably stable, despite major changes in the bed supply. Approximately two thirds of long-stay patients were aged 75 or older. Medical record review for a small sample of long-stay medical patients aged 75 or older revealed that 42 per cent of the days spent in hospital were spent either awaiting transfer to another level of care (home care, nursing home, or chronic care), or were due to in-hospital factors, such as awaiting consults, tests, or treatments. Hospital information systems and early discharge planning may help to alleviate lengthy discharge delays and result in better care for these patients.

Résumé

Résumé; Les conséquences des hospitalisations à long terme peuvent être graves, particulièrement chez les personnes âgées. Au Manitoba, entre les exercices 1991/1992 et 1999/2000, 40 p. 100 des journées d'hospitalisation de courte durée ont été utilisées par 5 p. 100 des patients qui avaient eu des hospitalisations prolongées, c'est-à-dire des séjours de plus de 30 jours. Ces proportions étaient remarquablement stables, malgré des changements importants quant au nombre de lits disponibles. Environ les deux tiers des patients de longue durée étaient âgés de 75 ans ou plus. L'étude des dossiers médicaux d'un petit échantillon des patients de longue durée, âgés de 75 ans ou plus, a révélé que 42 p. 100 des journées passées à l'hôpital avaient été passées soit à attendre un transfert vers un autre niveau de soins (soins à domicile, maison de soins infirmiers ou soins aux malades chroniques) soit à attendre en raison de facteurs propres à l'hô pital, notamment l'attente pour des consultations, des examens ou des traitements. Les systèmes d'information des hôpitaux ainsi que la planification des congés précoces des hôpitaux permettraient éventuellement d'alléger les longues attentes de congés et d'offrir de meilleurs soins à ces patients.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2005

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