Abstract
OBJECTIVES: to examine the relationship between seven predictor variables (recorded on Day 3 of hospital admission) and discharge destination in non-elective medical patients aged 65+ years. DESIGN: prospective cohort. SETTING: eight centres in six European countries. PREDICTOR VARIABLES: age, gender, living alone, physical function (three categories based on Barthel Index), cognition (Katzman's orientation-memory-concentration test), main body system affected (based on International Classification of Diseases), number of geriatric giants (GGs) involved in the referral (a GG being a problem with falling, mobility, continence or cognition). MAIN OUTCOME MEASURES: discharge destination (by Day 90) in three categories: 'HOMESAME' (return to previous residence), 'INSTIN90' (discharge to alternative residence or still in hospital at 90 days), 'DEADINHO' (death in hospital), RESULTS: in 1,626 patients, discharge destination was HOMESAME in 84.7%, DEADINHO in 8.9% and INSTIN90 in 6.4%. Mean duration of stay was 17.7 days, median 12. Univariate analyses showed a statistically significant relationship between all seven predictor variables and discharge destination. Physical function was the best single predictor with a seven-fold difference in adverse outcome rates between the best and worst categories. On multiple logistic regression, significant predictor variables were as follows. (i) For DEADINHO: physical function, cognition, gender; (ii) for INSTIN90: physical function, living alone, GGs, age, gender. Multiple linear regression identified physical function, GGs and living alone as predictors of loge length of stay. CONCLUSION: case-mix systems to compare risk-adjusted hospital outcome in older medical patients need to incorporate information about physical function, cognition and presenting problems in addition to diagnosis.
| Original language | English |
|---|---|
| Pages (from-to) | 467-475 |
| Number of pages | 9 |
| Journal | Age and Ageing |
| Volume | 34 |
| Issue number | 5 |
| Publication status | Published - Sep 2005 |
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ASJC Scopus subject areas
- Ageing
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A multi-centre European study of factors affecting the discharge destination of older people admitted to hospital : analysis of in-hospital data from the ACMEplus project. / Campbell, Susan E.; Seymour, D. Gwyn; Primrose, William R.; Lynch, Joanna E.; Dunstan, Edmund; Espallargues, Mireia; Lamura, Giovanni; Lawson, Peter; Philp, Ian; Mestheneos, Elizabeth; Politynska, Barbara; Raiha, Ismo.
In: Age and Ageing, Vol. 34, No. 5, 09.2005, p. 467-475.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A multi-centre European study of factors affecting the discharge destination of older people admitted to hospital
T2 - analysis of in-hospital data from the ACMEplus project.
AU - Campbell, Susan E.
AU - Seymour, D. Gwyn
AU - Primrose, William R.
AU - Lynch, Joanna E.
AU - Dunstan, Edmund
AU - Espallargues, Mireia
AU - Lamura, Giovanni
AU - Lawson, Peter
AU - Philp, Ian
AU - Mestheneos, Elizabeth
AU - Politynska, Barbara
AU - Raiha, Ismo
PY - 2005/9
Y1 - 2005/9
N2 - OBJECTIVES: to examine the relationship between seven predictor variables (recorded on Day 3 of hospital admission) and discharge destination in non-elective medical patients aged 65+ years. DESIGN: prospective cohort. SETTING: eight centres in six European countries. PREDICTOR VARIABLES: age, gender, living alone, physical function (three categories based on Barthel Index), cognition (Katzman's orientation-memory-concentration test), main body system affected (based on International Classification of Diseases), number of geriatric giants (GGs) involved in the referral (a GG being a problem with falling, mobility, continence or cognition). MAIN OUTCOME MEASURES: discharge destination (by Day 90) in three categories: 'HOMESAME' (return to previous residence), 'INSTIN90' (discharge to alternative residence or still in hospital at 90 days), 'DEADINHO' (death in hospital), RESULTS: in 1,626 patients, discharge destination was HOMESAME in 84.7%, DEADINHO in 8.9% and INSTIN90 in 6.4%. Mean duration of stay was 17.7 days, median 12. Univariate analyses showed a statistically significant relationship between all seven predictor variables and discharge destination. Physical function was the best single predictor with a seven-fold difference in adverse outcome rates between the best and worst categories. On multiple logistic regression, significant predictor variables were as follows. (i) For DEADINHO: physical function, cognition, gender; (ii) for INSTIN90: physical function, living alone, GGs, age, gender. Multiple linear regression identified physical function, GGs and living alone as predictors of loge length of stay. CONCLUSION: case-mix systems to compare risk-adjusted hospital outcome in older medical patients need to incorporate information about physical function, cognition and presenting problems in addition to diagnosis.
AB - OBJECTIVES: to examine the relationship between seven predictor variables (recorded on Day 3 of hospital admission) and discharge destination in non-elective medical patients aged 65+ years. DESIGN: prospective cohort. SETTING: eight centres in six European countries. PREDICTOR VARIABLES: age, gender, living alone, physical function (three categories based on Barthel Index), cognition (Katzman's orientation-memory-concentration test), main body system affected (based on International Classification of Diseases), number of geriatric giants (GGs) involved in the referral (a GG being a problem with falling, mobility, continence or cognition). MAIN OUTCOME MEASURES: discharge destination (by Day 90) in three categories: 'HOMESAME' (return to previous residence), 'INSTIN90' (discharge to alternative residence or still in hospital at 90 days), 'DEADINHO' (death in hospital), RESULTS: in 1,626 patients, discharge destination was HOMESAME in 84.7%, DEADINHO in 8.9% and INSTIN90 in 6.4%. Mean duration of stay was 17.7 days, median 12. Univariate analyses showed a statistically significant relationship between all seven predictor variables and discharge destination. Physical function was the best single predictor with a seven-fold difference in adverse outcome rates between the best and worst categories. On multiple logistic regression, significant predictor variables were as follows. (i) For DEADINHO: physical function, cognition, gender; (ii) for INSTIN90: physical function, living alone, GGs, age, gender. Multiple linear regression identified physical function, GGs and living alone as predictors of loge length of stay. CONCLUSION: case-mix systems to compare risk-adjusted hospital outcome in older medical patients need to incorporate information about physical function, cognition and presenting problems in addition to diagnosis.
UR - http://www.scopus.com/inward/record.url?scp=24644479005&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=24644479005&partnerID=8YFLogxK
M3 - Article
C2 - 16043443
AN - SCOPUS:24644479005
VL - 34
SP - 467
EP - 475
JO - Age and Ageing
JF - Age and Ageing
SN - 0002-0729
IS - 5
ER -