Abstract
Aim: To evaluate the evolution of the functional profile of older adults admitted to a health unit in Portugal; to relate the functional profile of these individuals with age, sex, education level and emotional state; and to evaluate the probability of the degree of dependence as a function of age and sex. Methods: longitudinal, retrospective study with a sample of 59,013 older adults admitted to convalescence units of the National Network of Integrated Continuous Care of Portugal. Results: In the first 75 days of hospitalization, activities of daily living, mobility and cognitive state improved, but there was a decline after 75 days of hospitalization. The ability to perform instrumental activities of daily living improved in the first 15 days of hospitalization, stabilized until 45 days and then began to worsen. Women had a higher probability of having a severe/complete dependence three years earlier than men (88 years to 91 years). A higher education level and stable emotional state were protective factors against functional decline. Conclusions: The functional profile of older adults improved during the length of stay recommended for hospitalization in convalescence units (30 days). It is critical for health systems to adopt strategies to prevent declines in the emotional state of frail individuals.
Highlights
With the increasing aging of the population and the increase in life expectancy, it is necessary to pay greater attention to the health of older adults
The majority of older adults admitted to Convalescence Units (CUs) were in the age group of 75 to 84 years (47.2%), followed by 65 to 74 years (29.0%), and last, people aged 85 or older (23.8%)
There was a significant improvement in the functional profile of older adults hospitalized in these units, and there was a decline in those who remained beyond 75 days
Summary
With the increasing aging of the population and the increase in life expectancy, it is necessary to pay greater attention to the health of older adults. The European Pathway Association states that for care pathways to be successful, they must obey a set of principles, among which the following stand out: (a) the definition of clear care goals, based on scientific evidence, the best clinical practices and the expectations and characteristics of the person being cared for; (b) the facilitation of communication among all those involved; (c) effective coordination; (d) the correct monitoring and evaluation of results; and (e) the identification of the appropriate resources for the individual and the clinical situation [1] In this sense, a care pathway should be based on both the integration of care and the continuity of care [2]. Recent data confirm that integrated care models have had benefits in improving the health-related quality of life and functionality of people with multimorbidity and frailty [5]; in reducing hospitalization and readmission rates [6]; in reducing polypharmacy [7]; and in improving patient satisfaction, perceived quality of care and access to services [8]
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