Patients 21 days or more in an acute hospital bed: Appropriateness of care |
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Authors: | Mary Hynes B P O’Herlihy Marie Laffoy Christine Hayes |
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Institution: | 1. Eastern Health Board, Cromcastle Road, Coolock, Dublin 5
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Abstract: | Patients occupying beds for 21 days or more in acute hospitals were studied. Using predetermined objective criteria, the appropriateness
of the previous day’s hospitalisation was assessed. Barriers to appropriate care and the level of care required were identified
in those deemed inappropriate. Of the 421 patients identified, 194 were considered to be inappropriately placed in an acute
hospital bed. Patients deemed inappropriate were more likely to be older (p<0.05), female (p<0.05), have lost a spouse (p<0.05),
have been admitted through the Accident and Emergency Department (p<0.05), and have longer lengths of stay (p<0.001) than
those considered appropriate. The most frequently identified barrier to appropriate care (N=143) was that the patient was
awaiting another level of care. The level of inappropriate use of acute beds in Dublin is unacceptably high. Additional longstay
accommodation especially for geriatric patients is needed. Alternatives to acute hospital care for patients requiring rehabilitation
or nursing care should be explored. |
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Keywords: | |
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