Trends in elderly patients (65 and over) waiting for long stay care in Edinburgh general hospitals 1988-1994

Five surveys carried out in Edinburgh nonpsychiatric general hospitals between 1988 and 1994 have shown a progressive drop in the number of elderly patients (65 and over) waiting for long stay care. The overall point prevalence rate has fallen from 21.2% in 1988 to 9.2% in 1994. All three specialty categories (Geriatric Assessment, Geriatric Orthopaedic and General Medical) which have high prevalences have shown falls with the largest fall occurring in General Medical beds from 13.4% in 1988 to 3.8% in 1994. A substantial percentage (61.6%) of patients surveyed in 1994 were waiting to go into Private Nursing Homes which is in stark contrast to 8.5% in 1988, whereas the reverse has happened with those waiting for NHS Geriatric Long Stay care falling from 75% to 12.8%. It appears that the Community Care legislation has accelerated the shift toward Private Nursing Home care but has not, as feared, increased the number of old people waiting for long stay care in Edinburgh hospitals. The number of elderly patients awaiting long stay care in acute general medical beds in Edinburgh has now reached acceptable levels. If the same trend is occurring elsewhere in Scotland, we believe that attention should now turn to monitoring inappropriate early discharge of elderly patients.