IDENTIFICATION OF GERIATRIC INPATIENTS IN THE CITY OF HAMBURG

In the past the calculation for an in-patient special offer (quantity of beds needed) was mainly carried out by diagnosis-based statistics o f hospital cases. The decision for an in-patient care within a geriatr ic unit is however influenced by factors as ''status of self-help abil ities'', ''social situation'' and ''co-morbidity''. Those factors are investigated either directly by the help of the patient himself or by questioning the nurses and/or the medical staff. A new way of measurin g will be introduced for this questioning. The crucial element is the Barthel-Index (BI). Supporting measures are done by the inclusion of m ain datas concerning the social situation as well as recording the mod ified screening according Lachs. From the 6th of September until 14th of December 1997 the three-part measuring technique was used at seven hospitals in Hamburg (amongst them one University hospital and one hos pital with a geriatric unit) within the framework of a representative sample survey. These collected datas register 18 admission days of all patients of sixty or over who at the time of questioning stayed for f ive days in one of those acute hospitals. In some hospitals some addit ional datas were collected at the third or 6th day after admission. Al together a whole ''virtual day-admission'' of the 60 years old or olde r patients was collected for the City of Hamburg at the 5th day after admission. Out of 425 patients 137 were moved or exmitted before quest ioning, 4 had already died. Out of the rest of 284 patients two of the m refused the questioning, whilst the datas of 6 patients were not fea sible for evaluating. Finally 276 patients were questioned. Out of the m 231 patients are ''not potential candidates for a geriatric hospital or a geriatric day-care unit'', 8 are ''candidates for a geriatric da y-care unit directly after discharge of primary care'' and 37 are ''ca ndidates for an in-patient geriatric hospital''. The presented three-p art question-sheet shows a sensitivity of 89.2% and a specification of 92.2%. This measuring technique in the hands of a trained examiner ap pears to be a valid and manageable tool in the framework of geriatric consultation as well as for the investigation of own directly ascertai ned statistic datas for ''potential candidates for an in-patient geria tric hospital''.