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[Optimization of outpatient polyclinic resources for emergency conditions in the elderly and old age.]
A N Ilnitski1,2, A G Kuznetsova1, E V Fesenko1
1Academy of Postgraduate Education under the Federal State Budgetary Unit «Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency», 91 Volokolamskoe highway, Moscow 125371, Russian Federation,
Abstract:
The study was conducted to optimize the handling of elderly and elderly patients in emergency conditions at the clinic by using an express survey to identify aging syndrome. The study involved 333 patients aged 65-90 who visited the emergency department of the polyclinic, 234 of whom were diagnosed with dementia syndrome using a rapid response questionnaire «The validated index for detecting aging syndrome in the emergency department of the clinic». When analyzing the case score after 1 month, statistically significant differences were found (p<0,001). In the 1st group, after 1 month 62,8% of patients were under observation by a district physician-therapist, in the 2nd group 41,4%. Without medical supervision, 43,4% of patients remained in the 2nd group and 29,5% in the 1st group. In the 2nd group, the number of fatalities was higher than in the 1st group: 2 and 0,4%, respectively. In the 2nd group, there were repeated requests to the emergency department (6,1%) unlike the 1st group (0%). Thus, the 1st group is characterized by: higher levels of medical surveillance, absence of repeated referrals, lower lethality. In the 2nd group, patients are more often left unmonitored, showing higher rates of retreatment and mortality.
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