Valoración Geriátrica Integral
- Predicting Hospital Admission for Older Emergency Department Patients: Insights From Machine Learning
- Old and New Geriatric Screening Tools in a Belgian Emergency Department: A Diagnostic Accuracy Study – Heeren – – Journal of the American Geriatrics Society
- Frailty Index and functional level upon admission predict hospital outcomes: an interRAI-based cohort study of older patients in post-acute care hospitals | BMC Geriatrics | Full Text
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Archivo de la categoría: Scoop.it
Hospitals are considered a setting ill-prepared for end of life issues; therefore, use of such acute care services has to be considered an indicator of poor quality end of life care. This study examines predictors of ERVH prior to death among HPC home care clients.
Methods: A retrospective cohort study of a sample of 764 HPC home care clients who received services from a community care access centre (CCAC) in southern Ontario, Canada.
All clients were assessed using the Resident Assessment Instrument for Palliative Care (interRAI PC) as part of normal clinical practice between April 2008 and July 2010. The Andersen-Newman framework for health service utilization was used as a conceptual model for the basis of this study.
Logistic regression and Cox regression analyses were carried out to identify predictors of ERVH.
Results: Half of the HPC clients had at least one or more ERVH (n = 399, 52.2%). Wish to die at home (OR = 0.54) and advanced care directives (OR = 0.39) were protective against ERVH.
Unstable health (OR = 0.70) was also associated with reduced probability, while infections such as prior urinary tract infections (OR = 2.54) increased the likelihood of ERVH. Clients with increased use of formal services had reduced probability of ERVH (OR = 0.55).
Conclusions: Findings of this study suggest that predisposing characteristics are nearly as important as need variables in determining ERVH among HPC clients, which challenges the assumption that need variables are the most important determinants of ERVH.
Ongoing assessment of HPC clients is essential in reducing ERVH, as reassessments at specified intervals will allow care and service plans to be adjusted with clients’changing health needs and end of life preferences.
Author: Lialoma Salam-WhiteJohn P HirdesJeffrey W PossJane Blums
Source: BMC Palliative Care 2014, 13:35
The interRAI Acute Care instrument incorporated in an eHealth system for standardized and web-based geriatric assessment..
The BelRAI-software allows standardized transmural information transfer and the centralization of medical, allied health professionals and nursing data. It is strictly secured and follows strict privacy regulations, allowing hospitals to optimize (transmural) communication and interaction. Howeve… Sigue leyendo
Starting this spring, frontline officers with the Ontario Provincial Police (OPP) will use a screening tool developed at Waterloo to assess mental health issues, allowing for improved transitions from police custody to hospital care. The Brief Mental Health Screener (BMHS) is a standardized, scie… Sigue leyendo