Department of Vascular Surgery, Ysbyty Gwynedd Hospital, Bangor, LL57 2PW, UK.
BMC Health Serv Res. 2012 Nov 20;12:410. doi: 10.1186/1472-6963-12-410.
Elderly patients are potentially more vulnerable to prolonged hospital stay as they frequently require additional resources to facilitate their discharge. In an acute hospital setting, we aimed to quantify and compare length of stay (LOS) for all patients over and under the age of 65, and identify the number and cause of days lost under the care of a single surgical unit.
Over a 4 month period from January to April 2010, data on the management and source of potential delay was collected daily on consecutive patients admitted and discharged under the care of one consultant surgeon at a district general hospital. Statistical analysis was then performed with particular focus on actual delays affecting elderly patients.
A total of 99 complete inpatients episodes were recorded. There were 30 elective and 69 acute admissions. 10 (33%) elective vs. 42 (61%) acute patients encountered delays, losing 39 and 232 days respectively (χ2 [1, N = 99] = 6.36, p = .012). 23 of a total 39 elderly patients admitted acutely required specialist care of the elderly opinion and placement in community hospitals resulting in delays of 188 days. vs. 36 days for the 16 discharged home and 8 days for 30 patients under 65 (χ2 (2, N = 69) = 26.54, p = <.001).
Elderly patients experiencing acute surgical admission and discharge to community hospitals had prolonged LOS due to significant delays associated with care of the elderly provision. The financial considerations behind bed capacity in primary and secondary care and the provision of care of elderly services need to be balanced against unnecessary occupancy of acute hospital beds with its associated health and economic implications.
老年人在医院的住院时间可能会更长，因为他们通常需要额外的资源来帮助他们出院。在急性医院环境中，我们的目的是量化和比较所有 65 岁以上和以下患者的住院时间（LOS），并确定单个外科病房护理下失去的天数数量和原因。
在 2010 年 1 月至 4 月的 4 个月期间，我们每天连续收集一名顾问外科医生照顾下入院和出院的患者的管理和潜在延迟源的数据。然后进行统计分析，特别关注影响老年患者的实际延迟。
共记录了 99 例完整的住院患者。有 30 例择期和 69 例急性入院。10 例（33%）择期患者和 42 例（61%）急性患者遇到了延迟，分别失去了 39 天和 232 天（χ2 [1, N=99] = 6.36，p=0.012）。23 名急性入院的老年患者需要老年专科医生的治疗意见，并安置在社区医院，导致延迟 188 天。相比之下，16 名出院回家的患者和 30 名 65 岁以下的患者分别需要 36 天和 8 天（χ2（2，N=69）= 26.54，p<0.001）。
因老年医疗服务的提供相关的重大延误，经历急性手术入院和出院至社区医院的老年患者的 LOS 延长。初级和二级保健中床位容量的经济考虑因素以及老年服务的护理提供需要与急性医院床位的不必要占用及其相关的健康和经济影响相平衡。
