What obstacles to nursing home for Dependent older adults’ entry? Analysis of 186 situations resulting from an...

The decision to admit an older adult with loss of autonomy to an institution is complex. There are many obstacles to the decision to be referred to an institution and it partly explain long hospital stays and inadequate health care spending. Several of these obstacles have been identified in the literature (medical complexity, psycho-behavioural disorders, social vulnerability, etc.). This work is based on an experiment that aimed at coordinating the players during an “inter-hospital consultation meeting” dedicated to the decision to admit older patients who cannot find a solution immediately. This work aim to identify the obstacles to the referral of patients to HITH services. This is a single-centre descriptive study. It analyses prospective data collected between January 2017 and the end of June 2019. The average length of hospitalisation before leaving the institution is relatively homogeneous according to the different complexity criteria defined, except for heavy dependence and obesity, where in these situations there are longer average lengths of hospitalisation. The absence of complexity criteria is not necessarily associated with a shorter hospital stay. The commission makes it possible to create synergies between players in the same gerontological basin and facilitates the admission of complex cases to hospital.