Alternativa a la hospitalización convencional en los pacientes mayores con fragilidad

Abstract

Introduction

The growing population of elderly people with multimorbidity and frailty requires care models tailored to their specific needs. Subacute care units in intermediate care hospitals have emerged as an effective alternative to conventional hospitalisation in acute care settings. Appropriate patient selection is essential to enable the early identification of patients who may require prolonged care and to ensure efficient turnover. The objectives of this study were: i) to describe the characteristics of patients’ admitted and process indicators and; ii) to analyse potential factors associated with prolonged hospital stays (≥ 13 days).

Methods

Retrospective study was conducted including 208 patients admitted to a subacute care unit between January and December 2023. Demographic, clinical and functional variables were collected, as well as the reason for admission, prior healthcare resourcesuse, discharge destination, and readmission.

Results

The mean age was 82,5 ± 14,3 years, with a mean VIG-Frail score of 0.39 ± 0.13 and an average comorbidity of 6,8 ± 2,5. The median length of stay was 10,0 (P25:7; P75:13) days. A total of 67.3% of patients were discharged home, 85,7% of whom did so within 13 days. Patients identified as complex chronic cases prior to admission were more likely a mean length of stay ≥13 days (44,7 vs. 69,2%; P=.055).

Conclusions

Our unit is consolidated as an effective alternative to acute hospitalisation, enabling crisis management in elderly people with multimorbidity and frailty, and facilitating a time return home.