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Emergency department admissions, older people, functional decline, and length of stay in hospital
Author(s)David A Conforti, David Basic, Jeffrey T Rowland
Journal titleAustralasian Journal on Ageing, vol 23.4, December 2004
PublisherBlackwell Publishing, December 2004
Pagespp 189-194
Sourcehttp://www.cota.org.au / http://www.blackwellpublishingasia.com
KeywordsMobility ; Self care capacity ; Mental disorder ; Admission [hospitals] ; Accident & emergency depts ; Discharge [hospitals] ; Australia.
AnnotationEarly identification of patients at risk of prolonged admission to hospital may allow targeted management decisions and discharge planning to begin in the emergency department. This study evaluated the effect of recent decline in function on length of stay (LOS) in hospital of 469 patients (mean age 79.4) presenting in the emergency department of hospital in Sydney, who were comprehensively assessed by a nurse practitioner. The Modified Barthel Index (MBI) and a range of other instruments were used to measure recent decline in function. Using multivariate survival analysis, the influence of MBI change on LOS was modelled in 249 randomly selected patients and validated in the remaining 220. In total, 327 patients (69.7%) were admitted to the hospital for a median LOS of 10 days. In the modelling sample, variables significantly associated with LOS included MBI change, whether known to the Aged Care Assessment Team (ACAT), and Waterlow score. Recent functional decline predicts LOS in the hospital, and is easy to measure in the emergency department, and may prove useful across the full spectrum of disease. It should be considered when formulating diagnostic and management plans, and when developing funding models. (RH).
Accession NumberCPA-050202217 A
ClassmarkC4: CA: E: LD:QKH: LD6: LD:QKJ: 7YA

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