Two European Examples of Acute Geriatric Units Located Outside of a General Hospital for Older Adults With Exacerbated Chronic Conditions.
Geriatrics
acute care
model of care
post-acute care
Journal
Journal of the American Medical Directors Association
ISSN: 1538-9375
Titre abrégé: J Am Med Dir Assoc
Pays: United States
ID NLM: 100893243
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
received:
09
09
2020
revised:
15
12
2020
accepted:
19
12
2020
pubmed:
2
2
2021
medline:
2
7
2021
entrez:
1
2
2021
Statut:
ppublish
Résumé
Throughout Europe, the number of older adults requiring acute hospitalization is increasing. Admission to an acute geriatric unit outside of a general hospital could be an alternative. In this model of acute medical care, comprehensive geriatric assessment and rehabilitation are provided to selected older patients. This study aims to compare patients' diagnoses, characteristics, and outcomes of 2 European sites where this care occurs. Exploratory cohort study. Subacute Care Unit (SCU), introduced in 2012 in Barcelona, Spain, and the Acute Geriatric Community Hospital (AGCH), introduced in 2018 in Amsterdam, the Netherlands. The main admission criteria for older patients were acute events or exacerbations of chronic conditions, hemodynamic stability on admission, and no requirement for complex diagnostics. We compared setting, characteristics, and outcomes between patients admitted to the 2 units. Data from 909 patients admitted to SCU and 174 to AGCH were available. Patients were admitted from the emergency department or from home. The mean age was 85.8 years [standard deviation (SD) = 6.7] at SCU and 81.9 years (SD = 8.5) (P < .001) at AGCH. At SCU, patients were more often delirious (38.7% vs 22.4%, P < .001) on admission. At both units, infection was the main admission diagnosis. Other diagnoses included heart failure or chronic obstructive pulmonary disease. Five percent or less of patients were readmitted to general hospitals. Average length of stay was 8.8 (SD = 4.4) days (SCU) and 9.9 (SD = 7.5) days (AGCH). These acute geriatric units are quite similar and both provide an alternative to admission to a general hospital. We encourage the comparison of these units to other examples in Europe and suggest multicentric studies comparing their performance to usual hospital care.
Identifiants
pubmed: 33524341
pii: S1525-8610(20)31101-4
doi: 10.1016/j.jamda.2020.12.034
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1228-1234Investigateurs
R Franssen
(R)
W J Frenkel
(WJ)
M J Henstra
(MJ)
M A van Maanen
(MA)
I Oudejans
(I)
J L Parlevliet
(JL)
E P van Poelgeest
(EP)
M N Resodikromo
(MN)
K J Kaland
(KJ)
N van der Velde
(N)
M E Visser
(ME)
H C Willems
(HC)
Informations de copyright
Copyright © 2021 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.