@article{ba1305ed1dcc4bd6bbc94ada002ab7ad,
title = "Two European Examples of Acute Geriatric Units Located Outside of a General Hospital for Older Adults With Exacerbated Chronic Conditions",
abstract = "Objective: Throughout Europe, the number of older adults requiring acute hospitalization is increasing. Admission to an acute geriatric unit outside of a general hospital could be an alternative. In this model of acute medical care, comprehensive geriatric assessment and rehabilitation are provided to selected older patients. This study aims to compare patients' diagnoses, characteristics, and outcomes of 2 European sites where this care occurs. Design: Exploratory cohort study. Setting and participants: Subacute Care Unit (SCU), introduced in 2012 in Barcelona, Spain, and the Acute Geriatric Community Hospital (AGCH), introduced in 2018 in Amsterdam, the Netherlands. The main admission criteria for older patients were acute events or exacerbations of chronic conditions, hemodynamic stability on admission, and no requirement for complex diagnostics. Measures: We compared setting, characteristics, and outcomes between patients admitted to the 2 units. Results: Data from 909 patients admitted to SCU and 174 to AGCH were available. Patients were admitted from the emergency department or from home. The mean age was 85.8 years [standard deviation (SD) = 6.7] at SCU and 81.9 years (SD = 8.5) (P < .001) at AGCH. At SCU, patients were more often delirious (38.7% vs 22.4%, P < .001) on admission. At both units, infection was the main admission diagnosis. Other diagnoses included heart failure or chronic obstructive pulmonary disease. Five percent or less of patients were readmitted to general hospitals. Average length of stay was 8.8 (SD = 4.4) days (SCU) and 9.9 (SD = 7.5) days (AGCH). Conclusions and Implications: These acute geriatric units are quite similar and both provide an alternative to admission to a general hospital. We encourage the comparison of these units to other examples in Europe and suggest multicentric studies comparing their performance to usual hospital care.",
keywords = "Geriatrics, acute care, model of care, post-acute care",
author = "Ribbink, {Marthe E.} and Neus Gual and MacNeil-Vroomen, {Janet L.} and {Ars Ricart}, Joan and Buurman, {Bianca M.} and Marco Inzitari and {AGCH-Study Group} and R. Franssen and Frenkel, {W. J.} and Henstra, {M. J.} and {van Maanen}, {M. A.} and I. Oudejans and Parlevliet, {J. L.} and {van Poelgeest}, {E. P.} and Resodikromo, {M. N.} and Kaland, {K. J.} and {van der Velde}, N. and Visser, {M. E.} and Willems, {H. C.}",
note = "Funding Information: Funding sources: The research conducted at the Subacute Care Unit (Parc Sanitari Pere Virgili) did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The Acute Geriatric Community Hospital (AGCH, Amsterdam University Medical Centers) research receives funding though ZonMw, the Netherlands Organization for Health Research and Development, project number 808393598041. Moreover, the care provided at the AGCH is provided in a partnership between Cordaan, a community and home care organization and the Amsterdam University Medical Center, location Academic Medical Center. The AGCH is financially supported by Zilveren Kruis, a health insurance company. Funding Information: We would like to thank the Amsterdam Public Health- Aging and Later Life research line for providing funding for a work visit of the first author (M.R.) to the Research group on Aging, Frailty and care Transitions (Re-fit) at Parc Sanitari Pere Virgili in Barcelona. The authors thank all (care) professionals from Parc Sanitari Pere Virgili, the Amsterdam University Medical Centers, and Cordaan who work at the SCU and AGCH. We would also like to thank the members of the AGCH study group; these are the clinicians who work at the Geriatrics Department of the Amsterdam University Medical Centers and who have supported the data collection at the AGCH. Publisher Copyright: {\textcopyright} 2021 AMDA – The Society for Post-Acute and Long-Term Care Medicine Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = jun,
doi = "https://doi.org/10.1016/j.jamda.2020.12.034",
language = "English",
volume = "22",
pages = "1228--1234",
journal = "Journal of the American Medical Directors Association",
issn = "1525-8610",
publisher = "Elsevier Inc.",
number = "6",
}