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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
In-hospital morbidity and mortality among patients from residential respite care
Zi Yi Low1, Megan Storer2, Rebecca Tai3
1Departments of Continuing Care, Austin Health, Melbourne, Victoria, Australia.
Background:
Residential respite is an important support for many community-dwelling older Australians and their caregivers. Respite clients are often very frail with high or specific care needs. Little is known about the comparative outcomes of hospital admission between permanent residential aged care facility (RACF) residents and residential respite residents.
Aim:
To determine the number of residential respite clients admitted to an acute tertiary hospital, and compare characteristics and in-hospital outcomes with those of permanent residential care residents.
Methods:
Retrospective study of residential respite patients admitted to an Australian tertiary hospital between November 2014 and September 2017. Comparison groups: all RACF patients admitted during same period (general RACF group), and control group matched (2:1) for aged, gender and diagnosis.
Main Outcome Measures:
in-hospital mortality, hospital length of stay (LOS), in-hospital complications (including fall, delirium, pressure injury, Medical Emergency Team (MET) call). Comparisons adjusted for age, gender, presenting symptom and matching variable.
Results:
A total of 166 admissions from residential respite and 332 matched RACF controls identified from 4575 admissions for permanent RACF residents. Mortality was significantly higher in respite group versus general RACF group (15.1 vs 8.2%, P < 0.001) but not matched control group (15.1 vs 16.3%, P = 0.795). LOS was significantly higher in respite patients than either control group. Respite patients had significantly higher prevalence of in-hospital fall (10.8 vs 1.5%, P < 0.0001) and delirium (35.5 vs 17.7%, P < 0.001) than matched RACF controls. No significant differences were seen in in MET-call and pressure injury rates.
Conclusion:
Although residential respite recipients represent a minority of total residential aged care admissions, they are at high risk of poor outcomes. Prospective identification and timely intervention may improve quality of care for this vulnerable cohort.
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