DO GERIATRIC PROGRAMS DECREASE LONG-TERM USE OF ACUTE-CARE BEDS

OBJECTIVE: To determine whether the introduction of coordinated geriat ric and discharge planning services at teaching and community hospital s in Toronto has changed the number of beds occupied by patients await ing transfer to long-term care institutions. DESIGN: Retrospective rev iew of social work records for the period 1985-1992. SETTING: Two tert iary and four primary acute care hospitals in Metropolitan Toronto. PA RTICIPANTS: Hospitals were matched for location, acuity, and teaching affiliation. MAIN OUTCOME MEASURES: The numbers of beds occupied by pa tients awaiting transfer to nursing homes or chronic care hospitals we re noted. RESULTS: In those teaching and community hospitals that had introduced coordinated geriatric and discharge planning services, ther e was a reduction in the percentage of beds occupied by patients await ing long-term care placement(average -51%), whereas in hospitals witho ut geriatric services, the percentage of beds occupied by patients awa iting longterm care placement increased (average +25%) (P = .05 by Fis her's exact method, 95% confidence limit odds ratio 0, .9999). CONCLUS ION: The introduction of coordinated geriatric and discharge planning services was associated with a decrease in the percentage of beds occu pied by patients awaiting long-term care in both teaching and communit y hospitals.