TY - JOUR
T1 - Association of Vulnerability Screening on Hospital Admission with Discharge to Rehabilitation-Oriented Care after Acute Hospital Stay
AU - de Groot, Aafke J.
AU - Wattel, Elizabeth M.
AU - van Balen, Romke
AU - Hertogh, Cees M. P. M.
AU - van der Wouden, Johannes C.
N1 - Funding Information: This research received internal funding (Internal funding from the department of Medicine for Older People, Amsterdam University Medical Center). Publisher Copyright: © 2023 by The Korean Geriatrics Society.
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Background: The short Dutch Safety Management Screening (DSMS) is applied at hospital admission of all patients aged >70 years to assess vulnerability. Screening of four geriatric domains aims to prevent adverse outcomes and may support targeted discharge planning for post-acute care. We explored whether the DSMS criteria for acutely admitted patients were associated with rehabilitation-oriented care needs. Methods: This retrospective cohort study included communi-ty-dwelling patients aged ≥70 years acutely admitted to a tertiary hospital. We recorded patient demographics, morbidity, functional status, malnutrition, fall risk, and delirium and used descrip-tive analysis to calculate the risks by comparing the discharge destination groups. Results: Among 491 hospital discharges, 349 patients (71.1%) returned home, 60 (12.2%) were referred for geriatric rehabilitation, and 82 (16.7%) to other inpatient post-acute care. Non-home referrals increased with age from 21% (70–80 years) to 61% (>90 years). A surgical diagnosis (odds ratio [OR]=4.92; 95% confidence interval [CI], 2.03–11.95), functional decline represented by Katz-activities of daily living positive screening (OR=3.79; 95% CI, 1.76–8.14), and positive fall risk (OR=2.87; 95% CI, 1.31–6.30) were associated with non-home discharge. The Charlson Co-morbidity Index did not differ significantly between the groups. Conclusion: Admission diagnosis and vulnerability screening outcomes were associated with discharge to rehabilitation-oriented care in patients >70 years of age. The usual care data from DSMS vulnerability screening can raise awareness of discharge complexity and provide opportunities to support timely and person-alized transitional care.
AB - Background: The short Dutch Safety Management Screening (DSMS) is applied at hospital admission of all patients aged >70 years to assess vulnerability. Screening of four geriatric domains aims to prevent adverse outcomes and may support targeted discharge planning for post-acute care. We explored whether the DSMS criteria for acutely admitted patients were associated with rehabilitation-oriented care needs. Methods: This retrospective cohort study included communi-ty-dwelling patients aged ≥70 years acutely admitted to a tertiary hospital. We recorded patient demographics, morbidity, functional status, malnutrition, fall risk, and delirium and used descrip-tive analysis to calculate the risks by comparing the discharge destination groups. Results: Among 491 hospital discharges, 349 patients (71.1%) returned home, 60 (12.2%) were referred for geriatric rehabilitation, and 82 (16.7%) to other inpatient post-acute care. Non-home referrals increased with age from 21% (70–80 years) to 61% (>90 years). A surgical diagnosis (odds ratio [OR]=4.92; 95% confidence interval [CI], 2.03–11.95), functional decline represented by Katz-activities of daily living positive screening (OR=3.79; 95% CI, 1.76–8.14), and positive fall risk (OR=2.87; 95% CI, 1.31–6.30) were associated with non-home discharge. The Charlson Co-morbidity Index did not differ significantly between the groups. Conclusion: Admission diagnosis and vulnerability screening outcomes were associated with discharge to rehabilitation-oriented care in patients >70 years of age. The usual care data from DSMS vulnerability screening can raise awareness of discharge complexity and provide opportunities to support timely and person-alized transitional care.
KW - Frailty
KW - Patient discharge
KW - Rehabilitation
KW - Subacute care
KW - Transitional care
UR - http://www.scopus.com/inward/record.url?scp=85180910262&partnerID=8YFLogxK
U2 - https://doi.org/10.4235/agmr.23.0068
DO - https://doi.org/10.4235/agmr.23.0068
M3 - Article
C2 - 37691483
SN - 2508-4798
VL - 27
SP - 301
EP - 309
JO - Annals of geriatric medicine and research
JF - Annals of geriatric medicine and research
IS - 4
ER -