Do geriatric programs decrease long-term use of acute care beds?

OBJECTIVE

To determine whether the introduction of coordinated geriatric and discharge planning services at teaching and community hospitals in Toronto has changed the number of beds occupied by patients awaiting transfer to long-term care institutions.

DESIGN

Retrospective review of social work records for the period 1985-1992.

SETTING

Two tertiary and four primary acute care hospitals in Metropolitan Toronto.

PARTICIPANTS

Hospitals were matched for location, acuity, and teaching affiliation.

MAIN OUTCOME MEASURES

The numbers of beds occupied by patients awaiting transfer to nursing homes or chronic care hospitals were noted.

RESULTS

In those teaching and community hospitals that had introduced coordinated geriatric and discharge planning services, there was a reduction in the percentage of beds occupied by patients awaiting long-term care placement (average-51%), whereas in hospitals without geriatric services, the percentage of beds occupied by patients awaiting long-term care placement increased (average + 25%) (P = .05 by Fisher's exact method, 95% confidence limit odds ratio 0, .9999).

CONCLUSION

The introduction of coordinated geriatric and discharge planning services was associated with a decrease in the percentage of beds occupied by patients awaiting long-term care in both teaching and community hospitals.