Abstract

Objective: To explore if direct admission from the emergency department to Sub-acute Care Unit of elderly adults with reactivated chronic diseases might be an alternative clinical pathway to conventional acute hospitalization.

Methods: A retrospective cohort study that examined geriatric patients aged 65 or over transferred directly from the emergency department to the Sub-acute Care Unit of the Hospital Sociosanitario Francolí in the initial 3-year period of implementation, from 1 January 2011 to 31 December 2013. We examined the sociodemographics characteristics, main medical di agnoses, and outcomes at discharge elaborated by Chronic Care Programme within the new Health Plan for Catalonia 2011-2015.

Results: We included 689 patients who were discharged to the Sub-acute Care Unit during the time period of the study. Mean age ± standard desviation=81.5 ± 8.5 years, 52% were women. The principal diagnoses for admission were respiratory system disorders (58%) and circulatory system disorders (21%). Global mean sub-acute length of stay was 16.3 days. All predefined quality standards were met in terms of outcomes at discharge, with among 80% were return to their own home.

Conclusion: From our results, direct admission to sub-acute care unit might represent a potential alternative to acute hospitalization for selected elderly patients.

Keywords: Chronic care programme; Chronic diseases; Elderly patients; Emergency; Sub-acute care