January 2002
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3 Citations
Context: Specialization of classical (non geriatric) short-stay unit is less and less adequate to receive polymorbidity elderly patients. Architectural or financial hospital organisations were in France a real problem to perform elderly health better. Aim: To explain evaluations which allowed to plot propositions for a better reception of establishment (at the beginning in our service, 40 of the 80 beds were organized in community room). Methods: Factorial analysis between autonomy scale and ideal geriatric unit was made in 1992 (112 elderly patients from the comunity). Two months longitudinal investigation in 1995 (230 geriatric short stays with average age 84,6 +/- 6,5) had measured platform or not hospitalizations impact on duration of stay. Results: Factorial analysis proved the necessity of medical beds than social institution. After this study, it has been decided first to suppress insecurity and discomfort community rooms, on the other hand to create a mobile geriatric consultation team and programed beds process with the help of general practinioners. Mobile geriatric consultation team stabilized her activity between 320 and 360 consultations among classical units of hospital. The success of programmed beds process, give at the present time 4 weeks of expectation delay. Cumulative maladjusted days of long duration stays would permit 7 millions francs of economy in one year. Conclusion: Late structural delay to adjust establisments to medical geriatric requirement is very difficult to perform. Despite increase of activity with a better organisation (750 to 1850 hospitalisations from 1983 to 2000), it was necessary to initiate a new project to receive elderly patients in a 7 beds unit nearly emergency room.