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Where to go if not the hospital? Reviewing geriatric bed utilization in an acute care hospital in Singapore.

Publication ,  Journal Article
Zhou, K; Vidyarthi, AR; Wong, CH; Matchar, D
Published in: Geriatr Gerontol Int
October 2017

AIM: Singapore is one of the fastest-aging countries in the world, and the demand for acute hospital care for older adults is expected to triple in the next 25 years. Hence, it is crucial to understand the opportunities in reducing potentially avoidable bed days (PABD), which are days spent in acute hospitals delivering only non-acute services. We aimed to access the prevalence, causes and consequences of PABD among geriatric patients. METHODS: We examined all hospitalizations from 1 August through 31 December 2013 in the geriatric wards of an acute hospital in Singapore. PABD were identified using a modified Appropriateness Evaluation Protocol. Non-acute services were classified as subacute care, rehabilitative care, long-term care or social care. Hospitalization patterns were determined based on the presence or absence of non-acute services, and multinomial logistic regression was used to determine predictors of different patterns. RESULTS: Of the 273 bed days used by 254 patients, 49% were potentially avoidable. The most common non-acute services provided were rehabilitative care (19%), subacute care (12%) and long-term care (8%). New acute issues arose after the admission conditions subsided in 2.4% of hospitalizations, 61% of which were nosocomial infections. Being socially at risk as assessed on admission predicted the development of new acute issues (sensitivity = 62%; specificity = 88%). CONCLUSIONS: In the present study, almost half of the bed days were potentially avoidable. New acute issues can arise after PABD, which are dangerous to these frail older adults. Proactive discharge planning and increasing access to intermediate and long-term care services are required to reduce PABD. Geriatr Gerontol Int 2017; 17: 1575-1583.

Duke Scholars

Published In

Geriatr Gerontol Int

DOI

EISSN

1447-0594

Publication Date

October 2017

Volume

17

Issue

10

Start / End Page

1575 / 1583

Location

Japan

Related Subject Headings

  • Subacute Care
  • Singapore
  • Male
  • Logistic Models
  • Humans
  • Hospitalization
  • Health Services for the Aged
  • Gerontology
  • Female
  • Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Zhou, K., Vidyarthi, A. R., Wong, C. H., & Matchar, D. (2017). Where to go if not the hospital? Reviewing geriatric bed utilization in an acute care hospital in Singapore. Geriatr Gerontol Int, 17(10), 1575–1583. https://doi.org/10.1111/ggi.12936
Zhou, Ke, Arpana R. Vidyarthi, Chek Hooi Wong, and David Matchar. “Where to go if not the hospital? Reviewing geriatric bed utilization in an acute care hospital in Singapore.Geriatr Gerontol Int 17, no. 10 (October 2017): 1575–83. https://doi.org/10.1111/ggi.12936.
Zhou K, Vidyarthi AR, Wong CH, Matchar D. Where to go if not the hospital? Reviewing geriatric bed utilization in an acute care hospital in Singapore. Geriatr Gerontol Int. 2017 Oct;17(10):1575–83.
Zhou, Ke, et al. “Where to go if not the hospital? Reviewing geriatric bed utilization in an acute care hospital in Singapore.Geriatr Gerontol Int, vol. 17, no. 10, Oct. 2017, pp. 1575–83. Pubmed, doi:10.1111/ggi.12936.
Zhou K, Vidyarthi AR, Wong CH, Matchar D. Where to go if not the hospital? Reviewing geriatric bed utilization in an acute care hospital in Singapore. Geriatr Gerontol Int. 2017 Oct;17(10):1575–1583.
Journal cover image

Published In

Geriatr Gerontol Int

DOI

EISSN

1447-0594

Publication Date

October 2017

Volume

17

Issue

10

Start / End Page

1575 / 1583

Location

Japan

Related Subject Headings

  • Subacute Care
  • Singapore
  • Male
  • Logistic Models
  • Humans
  • Hospitalization
  • Health Services for the Aged
  • Gerontology
  • Female
  • Aged