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[Identification of acute geriatric patients in the city of Hamburg ("direct data collection")]
M Willkomm1, G Jansen, R Thode
1DRK-Therapiezentrum Middelburg, Süsel. TZMiddelburg@leubeck.netsurf.de
Insights
A new three-part questionnaire, utilizing the Barthel Index, accurately identifies elderly patients needing geriatric hospital care. This method improves upon traditional diagnosis-based statistics for better resource allocation.
Area of Science:
- Geriatric Medicine
- Healthcare Management
- Patient Assessment
Context:
- Traditional methods for determining geriatric bed needs rely on diagnosis-based statistics.
- Geriatric care decisions are influenced by self-help abilities, social situation, and co-morbidity.
- Accurate patient assessment is crucial for effective geriatric resource allocation.
Purpose:
- To introduce and validate a new three-part measurement technique for assessing geriatric patient needs.
- To evaluate the effectiveness of the Barthel Index and modified Lachs screening in this assessment.
- To determine the proportion of elderly patients suitable for geriatric day-care or in-patient geriatric hospital admission.
Summary:
- A representative sample survey in seven Hamburg hospitals assessed 276 elderly patients using a novel three-part questionnaire.
- The questionnaire incorporated the Barthel Index and social/screening data to identify care needs.
- Results showed 37 patients were candidates for in-patient geriatric hospitals and 8 for geriatric day-care units.
Impact:
- The new measurement technique demonstrated high sensitivity (89.2%) and specificity (92.2%).
- This tool is a valid and manageable method for geriatric consultation and statistical data investigation.
- It offers improved accuracy for identifying potential in-patient geriatric hospital candidates compared to traditional methods.
Abstract:
In the past the calculation for an in-patient special offer (quantity of beds needed) was mainly carried out by diagnosis-based statistics of hospital cases. The decision for an in-patient care within a geriatric unit is however influenced by factors as "status of self-help abilities", "social situation" and "co-morbidity". Those factors are investigated either directly by the help of the patient himself or by questioning the nurses and/or the medical staff. A new way of measuring will be introduced for this questioning. The crucial element is the Barthel-Index (BI). Supporting measures are done by the inclusion of main data concerning the social situation as well as recording the modified screening according Lachs. From the 6th of September until 14th of December 1997 the three-part measuring technique was used at seven hospitals in Hamburg (amongst them one University hospital and one hospital with a geriatric unit) within the framework of a representative sample survey. These collected data register 18 admission days of all patients of sixty or over who at the time of questioning stayed for five days in one of those acute hospitals. In some hospitals some additional data were collected at the third or 6th day after admission. Altogether a whole "virtual day-admission" of the 60 years old or older patients was collected for the City of Hamburg at the 5th day after admission. Out of 425 patients 137 were moved or exmitted before questioning, 4 had already died. Out of the rest of 284 patients two of them refused the questioning, whilst the data of 6 patients were not feasible for evaluating. Finally 276 patients were questioned. Out of them 231 patients are "not potential candidates for a geriatric hospital or a geriatric day-care unit", 8 are "candidates for a geriatric day-care unit directly after discharge of primary care" and 37 are "candidates for an in-patient geriatric hospital". The presented three-part question-sheet shows a sensitivity of 89.2% and a specification of 92.2%. This measuring technique in the hands of a trained examiner appears to be a valid and manageable tool in the framework of geriatric consultation as well as for the investigation of own directly ascertained statistic datas for "potential candidates for an in-patient geriatric hospital".