The Effectiveness of Intermediate Care for Older Patients from a Community Hospital in Southern Taiwan

Chin-Jung Wu ； Yu-Ju Kuo ； Chin-Hsia Li ； Hsiao-Yu Lin ； Hsiao-Hung Huang ； Mao-Ju Wang ； Ta-Wei Luo

《台灣老年醫學暨老年學雜誌》 9卷2期 (2014/05) Pp. 16-16(2)

並列摘要

Background: Hospitalization is a risk factor for functional decline in elderly due to acute illness, and they may still need more care to adapt community-dwelling after discharge. Therefore, intermediate care is required to smooth transitions between hospital and home. Objective: This study is to investigate the effectiveness of intermediate care for older patients. Methods: A interventional study of multidisciplinary collaboration conducted in a community hospital of southern Taiwan. Patients aged 65 years and older who need intermediate care service after acute hospitalized were included and assessed due to Comprehensive Geriatric Assessment (CGA) in this study. The outcomes including ADL, IADL, MMSE, GDS, EQ-5D, MNA, and VAS-pain were compared before and after care plan. Results: 105 patients were included, with a mean age of 81.1±10.3 years. The discharge destination of those elderly, 89 (84.8%) successfully return to community-dwelling, 12(11.4%) admission to acute care unit because of conditions requiring, and 4(3.8%) transfer to long-term care facility. Furthermore, We found most CGA assessment outcomes have significantly improved from the patients who returning to communitydwelling, including the scoring of ADL from 36.4±23.6 to 55.6±26.3(p＜0.001), IADL from 1.7±1.8 to 2.0±1.8(p＜0.001), MMSE from 13.1±6.9 to 14.4±6.6(p＜0.001), EQ-5D from 8.5±1.8 to 7.6±1.6(p＜0.001), MNA from 9.6±2.8 to 11.1±2.4 (p＜0.001), and VAS-pain from 0.6±1.2 to 0.2±0.5 (p＜0.001). Despite the scoring of GDS have improved, but not statistically significant difference. Conclusion: The study showed that intermediate care is effective for older patients after acute hospitalized. However, which factors were likely to predict discharge home were unclear, further study would be executed.