LONG HOSPITAL STAYS AND NEED FOR ALTERNATE LEVEL OF CARE AT DISCHARGE- DOES FAMILY MAKE A DIFFERENCE FOR ELDERLY PATIENTS

OBJECTIVE To determine whether parental and marital status of elderly patients admitted to acute care affect the likelihood of a need for lo ng hospital stay or alternate level of care (nursing home) at discharg e. DESIGN A 1-year descriptive study was carried out prospectively on elderly hospitalized patients. Marital status and parental status were treated as risk factors for resource use, as were sex, age, admitting service, and diagnosis. SETTING A 672-bed university hospital. PATIEN TS We studied 495 patients aged 65 years or more sequentially admitted over a 1-year period. Excluded from study were critically ill patient s, patients admitted to intensive care, and patients with whom we coul d not communicate on the day they were considered for the study. MAIN OUTCOME MEASURES Whether acute hospital stay exceeded 44 days and need for alternate level of care at discharge. RESULTS Many (43.4%) of the patients had no spouse and 19.4% had no children; 32.9% stayed 45 day s or more and 6.9% required alternate level of care at discharge. Pred ictive of a long hospital stair were being without children (adjusted RR = 1.85), having a neurologic or psychiatric diagnosis (adjusted RR = 3.39), and having surgery unrelated to reason for admission (adjuste d RR = 5.88). Predictive of need for alternate level of care at discha rge were increasing age (adjusted RR = 1.08), having no spouse (adjust ed RR = 2.59), having no children (adjusted RR = 3.27), and having a n eurologic or psychiatric diagnosis (adjusted RR = 7.56). CONCLUSIONS A mong elderly hospitalized patients, familial status can predict long s tays and the need for placement.