187 Prospective study of patients admitted to a model 2 hospital

Abstract

Abstract Background Model 2 hospitals provide in-patient and out-patient care for differentiated, low-risk medical patients, who are not likely to require full resuscitation. Smaller hospitals are generally very well regarded by the local population and general practitioners. Methods This is a prospective descriptive study. Data were collected from all patients admitted via the Medical Assessment Unit (MAU) or stepped-down from a model 4 hospital for six consecutive weeks. Data points included: route of admission, age, Rockwood Clinical Frailty Scale (CFS) on presentation, length of stay (LOS), long term care/community resident, if delirium was present, known cognitive impairment, number of medications, hospital admissions in the past year and discharge destination. Results 144 patients were recruited to the study—79 via the MAU, 64 stepped down from a model 4 hospital and 1 via outpatient clinic, 95 of whom had a hospital admission within the previous year. The average age of patients was 72 years with a mean CFS of 4. 38% of patients were felt to be delirious on presentation to hospital, with 14% having a formal diagnosis of cognitive impairment prior to admission. Over 80% of patients were prescribed 5 or more medications in the community. Average overall LOS at the module 2 hospital was 9 days; 8 days for patients admitted via the MAU and 12 days for those stepped down from a model 4 hospital. The mean LOS at module 4 hospital prior to transfer was 6 days. 92% were living in the community prior to admission, 82% of which returned home. Conclusion Model 2 hospitals are a vital resource, particularly catering for the geriatric population. Patients are often multimorbid and admissions are often complicated with polypharmacy, delirium and discharge planning. Further exploration is required to assess how best to appropriately staff and resource them.