Abstract
Introduction
Gorseinon Hospital (GH) is a community rehabilitation facility which offers reablement following an acute admission to hospital. Patients are accepted from both medical and surgical specialty wards. Between 2015-2019 GH had median length of stay (LOS) 32 days. In 2018, 81% of patients returned to their own homes.
Methodology
A retrospective review of all admissions to GH from January to December 2021 (n= 256) to identify opportunities for service improvement.
Results
Median GH LOS was 53 days. Patients transferred from acute frailty and stroke services who received early Comprehensive Geriatric Assessment (CGA) were considered as a separate subgroup; this group (r-CGA) was compared to patients who did not receive early CGA (nr-CGA). The median overall LOS for group nr-CGA is 56 days vs r-CGA median of 51.5 days (Z = -2.591, p < 0.05). 18% of patients returned to the acute hospital. A detailed analysis showed 32.26% patients from general surgical wards returned to hospital. While the proportion of patients in the r-CGA group who returned to hospital was 16.33% and group nr-CGA 18.6%. Median LOS for COVID-19 positive patients was 79 days vs 52 days (p < 0.01). 66% of patients returned home; 13% were discharged to institutional care.
Conclusion
Patients were observed to have a longer length of stay at GH and an increased risk of being discharged to institutional care. Deconditioning associated with hospitalisation, Covid-19 infection and the lockdown periods enforced by the pandemic are potential factors. Early implementation of CGA is likely to reduce acute hospital returns and overall LOS.
Comments
It would be helpful to have more information regarding the case-mix of the patients to understand better the differences observed.