Revista Española de Salud Pública
Print version ISSN 1135-5727
BAZTAN, Juan J. et al. Functional Gain and Length of Hospital Stay at a Medium-Stay Geriatric Care Unit at the Central Red Cross Hospital in Madrid, Spain. Rev. Esp. Salud Publica [online]. 2004, vol.78, n.3, pp. 355-366. ISSN 1135-5727. http://dx.doi.org/10.1590/S1135-57272004000300005.
Background: The medium-stay or convalescent care geriatric units were defined by the Spanish National Health Institute in 1996 as being the level of geriatric hospital care aimed at recovering those functions, activities or sequelae having undergone changes as a result of different prior processes. This study is aimed at evaluating the characteristics of patients related to functional gain and stay in medium-stay geriatric units. Methods: A study was made of all those patients admitted throughout the May 2000-December 2001 period. The weekly and overall functional gain was evaluated using the Barthel Index (BI), the hospital stay and the effectiveness (BI at discharge-BI at admission/during stay) having been evaluated. An improvement in the weekly gain of BI>5 points was set at the effectiveness threshold. Results: A total of 459 patients averaging age 80.56 (±7.45) admitted for functional recovery from sequelae of ictus (48.4%), orthopedic disorders (26,3%) and immobility due to other ailments (23.5%) were evaluated. The total functional gain was 29.71 (±16.75) Barthel Index points, entailing an average stay of 24.93 (±12.94) days and a 1.44 (±1.02) effectiveness. The weekly functional gain was above the threshold set during the first three weeks, independently of the age and disorder for which admitted. In the multivariate regression analysis, the age, admission due to ictus, functional impairment prior to admission, cognitive impairment at admission, comorbility and delay in admission were related to a lesser functional gain. Admission due to ictus and a better functional condition prior to admission and better cognitive condition at admission were related to a longer stay. Conclusions: Hospital stays in medium-stay geriatric units is adequate, at least during the first three weeks. A comparison of the results among units should be adjusted by age, the disorder for which admitted, comorbility and functional and cognitive condition of the patients.
Keywords : Heath services for aged; Rehabilitation outcome; Hospital; Efficiency; Frail elderly.