Original studyOutcomes at 12 Months in a Population of Elderly Patients Discharged From a Rehabilitation Unit
Section snippets
Study Population and Setting
This study included all elderly (aged 65 years or older) patients consecutively and newly discharged from the RACU between May 1, 2004, and April 30, 2005. The RACU is an intermediate-care setting that offers a rehabilitative and clinical approach for patients requiring specialized care not routinely available in hospitals or nursing homes (NH). In particular, our RACU is a 60-bed ward devoted to the rehabilitation of postacute and chronic disabilities of frail and nonfrail elderly patients.
Results
During the study period, 1330 patients were discharged from the RACU consecutively and for the first time. Of these, 7 patients who were residents in a NH before RACU admission were excluded from further analyses. At the 12-month follow-up, 115 (8.7%) patients were untraceable at the telephonic interview and 136 (10.2%) had died; of the 1072 remaining, 90 (8.3%) were institutionalized (3.4% at discharge and 4.0% within the next l2 months) and 409 (8.0%) had 2 or more rehospitalizations.
Discussion
The main aim of this study was to identify the cognitive, functional, and clinical variables associated with the 12-month risk of institutionalization, rehospitalization, and death in a population of patients discharged from a RACU.
With regard to the risk of 12-month institutionalization, our rate is lower than those of other international studies.32, 33, 34, 35 Winograd et al,32 in a prospective cohort study of male veterans aged 65 years and older, found that 1 year after hospital discharge
Conclusion
This study was undertaken to assess the variables predicting 1-year rates of institutionalization, rehospitalization, and mortality among a population of elderly patients first and consecutively discharged from a RACU. Our purpose was to investigate factors susceptible of an intervention study performable in our area to organize preventive health care programs and home services. The findings clearly suggest that both modifiable and unmodifiable variables strongly impact outcomes (Table 8).
Acknowledgments
Sincere appreciation is due to Drs. Emanuela Barisione, Fabio Guerini, Elena Lucchi, Alessandra Marrè, Marco Pagani, Salvatore Speciale, and Renato Turco for their support in collecting data and to Elena Davelli for her revision of the manuscript in the English language.
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This study was supported by a grant from the ONLUS Foundation “Socialità e Ricerche,” Bergamo, Italy.