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Performance indicators for hospital services for older people
Yvonne Challiner1, G Iain Carpenter, Jonathan Potter
1East Kent Hospitals NHS Trust, Kent, UK. y.c.m.challiner@ukc.ac.uk
Age and Ageing
|May 2, 2003
Summary
Standardised assessments in geriatric rehabilitation reveal that patient factors like cognitive and physical function significantly influence discharge destinations, not just the hospital itself. These findings are crucial for accurate outcome comparisons.
Area of Science:
- Geriatric Medicine
- Rehabilitation Science
- Health Services Research
Background:
- Standardised assessment is crucial in geriatric practice for enhancing patient care and generating quality data.
- High-level performance indicators revealed disparities in discharge destinations from rehabilitation units between two hospitals.
Purpose of the Study:
- To evaluate if standardised assessment data can inform performance indicators for comparing hospital outcomes.
- To identify factors influencing discharge destinations in geriatric rehabilitation.
Main Methods:
- Prospective observational study involving consecutive patients admitted to geriatric rehabilitation wards.
- Utilised standard tools (Barthel, Abbreviated Mental Test) and interRAI MDS assessment system for mental and physical functioning, mood, and other factors.
- Recorded patient's residence prior to admission and discharge destination.
Main Results:
- Significant differences in discharge to residential/nursing homes were observed between hospitals initially.
- Multivariate analysis indicated increased risk of institutionalisation for women and patients with impaired cognitive and physical function.
- Hospital of care was not a significant predictor of discharge destination after adjusting for patient's functional status.
Conclusions:
- Hospital outcome comparisons in geriatric rehabilitation can be misleading without standardised patient functioning data.
- Standardised assessments provide essential insights into patient-specific factors affecting discharge destinations.
- Accurate performance indicators require incorporating comprehensive patient functional data.