Geriatric Day Hospital for elderly at risk of hospitalization

• Grant number: 14/50007-4
• Support Opportunities: Research Grants - Research in Public Policies for the National Health Care System (PP-SUS)
• Start date: July 01, 2014
• End date: December 31, 2015
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Agreement: CNPq - PPSUS
• Principal Investigator: Wilson Jacob Filho
• Grantee: Wilson Jacob Filho
• Host Institution: Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Demographic changes that are resulting in older populations pose a considerable challenge for Health Care Services around the world. Despite being 12% of the population, older adults account for more than 30% of the hospitalization costs in Brazil. For some frail patients, Geriatric Day Hospital (GDH) constitutes an alternative to avoid hospitalization. And, it constitutes a partial answer to the elderly escalating demand for healthservices. The purpose of this study is to determine the effectiveness of a GDH service in solving some health problems without hospitalization in a Public Hospital of São Paulo. Methods: Case study for feasibility analysis of a GDH service. Potential participants are older adults at risk of hospitalization referred from different sectors of HCFMUSP to treatment in the GDH. Included patients will be approached by Comprehensive Geriatric Assessment for planning a multidisciplinary treatment at HDG. The intervention will be based on the needs of the patient for a maximum period of three months. Discharge can occur anytime in accordance with the resolution of the reason for referral. Patients will be followed by phone calls monthly until six months after discharge for outcomes analysis: mortality, hospitalization and satisfaction. Results: 500 elderly will be assessed. It is expected a hospitalization and emergency room visit avoidance of 60% or more at the end of follow-up. Furthermore, it is believed an improvement of health condition in at least 80% of the patients at discharge accompanied by good reports of satisfaction. Finally, the study shows a new option, whenever possible, against the use of hospital beds. (AU)