Comparison of length of stay between direct entry and emergency admission in acute care geriatric unit after hotline regulation

Abstract

Development of the geriatric care allows direct hospitalization and avoid unnecessary emergency admissions. In Clermont-Ferrand, a specific hotline regulates direct entry from home and emergencies in the geriatric acute care unit. The aim of this study was to evaluate the impact of the entry mode (home or emergency) on the length of stay of patients hospitalized in acute care geriatric unit. We have retrospectively collected data on hospitalization of patients over 75 years in the Geriatric Acute care unit from January to March 2019. We also collected socio-demographic data, autonomy score, MMS, co-morbidity score, exit mode, previous year’s hospitalization and polymedication on hospitalization reports. We included 88 patients in the “direct” group and 184 patients in the “emergency” group. The characteristics of the two groups were comparable. The median length of stay for the “emergency” group was 14 days [9.5; 20] versus 12 [8.5; 18] for the “direct” group (p=0.03). In multivariate analysis, ADL score and home lifestyle were correlated with duration of stay. The development of direct entrance pathways into the geriatric short-stay department by establishing specific hotlines decreases length of stay.