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Admission Criteria in Short-term Geriatric Assessment Units

A Delphi Study

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Canadian Journal of Public Health Aims and scope Submit manuscript

Abstract

Background

In recent years, short-term geriatric care units that operate using an interdisciplinary approach have been established in Quebec and elsewhere, in order to provide frail elderly persons with better health care. The purpose of this study is to determine criteria that target the greatest number of individuals most likely to benefit from hospitalization in this type of care unit.

Methods

A Delphi survey was conducted. The panel of experts consisted of 54 physicians and nurses working in short-term geriatric care units in Quebec. Three questionnaires were mailed and 4-level Likert scales were used. Median values, and 25th and 75th percentiles to a maximum of 2, were chosen a priori as the definition of consensus.

Results

The survey used 14 inclusion criteria and 17 exclusion criteria. Inclusion criteria were divided into two categories and exclusion criteria were divided into four.

Interpretation

A typical clinical profile of a patient who should be admitted to a STGCU emerges: an elderly person presenting multiple pathologies, acute or sub-acute functional disability, and often related psychosocial problems. The instrument developed by this project is a practical guide for professionals in STGAUs as well as those responsible for allocating resources in the health care system.

Résumé

Objectif

Des unités de courte durée gériatriques (UCDG) offrant une approche de soins globale et interdisciplinaire ont été établies dans les hôpitaux généraux et spécialisés du Québec et d’ailleurs afin d’offrir aux personnes âgées fragiles des soins de santé adaptés à leurs besoins particuliers. L’objectif de la présente étude était d’établir les critères d’admissibilité ciblant le plus grand nombre de personnes à même de bénéficier d’une hospitalisation dans ce type de structure.

Méthode

Une enquête de type Delphi a été réalisée à cette fin. Le groupe d’experts était formé de 54 médecins et infirmières rattachés aux UCDG. L’enquête a été effectuée à l’aide de trois questionnaires postaux, et les réponses ont été mesurées selon une échelle de Likert à quatre niveaux. Un consensus a priori a été défini d’après les valeurs médianes, les 25e et 75e valeurs percentiles jusqu’à un maximum de 2.

Résultats

Un consensus a été obtenu autour de 14 critères d’inclusion et 17 critères d’exclusion. Les critères d’inclusion ont été regroupés en deux catégories, et les critères d’exclusion en quatre catégories. Un profil clinique type émerge de cette enquête: celui d’une personne âgée atteinte de multiples pathologies et d’un déclin fonctionnel aigu ou sub-aigu, souvent associé à des problèmes psychosociaux.

Conclusion

Ces critères apparaissent utiles à la fois pour les professionnels gérant les admissions en UCDG et pour les responsables de l’allocation des ressources dans notre système de santé.

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Author information

Authors and Affiliations

  1. Faculty of Medicine, Department of Family Medicine, Area of Health Services and Policy Research, McGill University, 515-517, Pine Avenue, Room 10, Montreal, Quebec, H2W 1S4, Canada

    Charo Rodríguez MD, PhD

  2. McGill Faculty of Management & Center for Strategy Studies in Organizations, Canada

    Charo Rodríguez MD, PhD

  3. Groupe de recherche interdisciplinaire en santé (GRIS), Université de Montréal, Canada

    Charo Rodríguez MD, PhD & André-Pierre Contandriopoulos PhD

  4. Institut universitaire de gériatrie de Montréal, Centre de recherche, Canada

    Marie-Jeanne Kergoat MD, Judith Latour MD & Paule Lebel MD, MSc

  5. Pavillon Hôtel-Dieu, Centre hospitalier de l’Université de Montréal (CHUM), Canada

    Judith Latour MD

  6. Direction de la santé publique de Montréal-Centre, Canada

    Paule Lebel MD, MSc

  7. Département d’administration de la santé, Université de Montréal, Canada

    André-Pierre Contandriopoulos PhD

Authors
  1. Charo Rodríguez MD, PhD
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  2. Marie-Jeanne Kergoat MD
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  3. Judith Latour MD
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  4. Paule Lebel MD, MSc
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  5. André-Pierre Contandriopoulos PhD
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Groupe de recherche sur l’évaluation de la prise en charge des personnes âgées fragiles

Corresponding author

Correspondence to Charo Rodríguez MD, PhD.

Additional information

This study is part of a research program funded by the National Health Research and Development Program (NHRDP) of Health Canada as part of the special “Programme de recherche sur l’autonomie des aîné(e)s” (PRAA). (Project No. 6605-4559-602).

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Rodríguez, C., Kergoat, MJ., Latour, J. et al. Admission Criteria in Short-term Geriatric Assessment Units. Can J Public Health 94, 310–314 (2003). https://doi.org/10.1007/BF03403551

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