Nutritional Quality of Meals, Food Intake, Physical Activity and Length of Stay Predict Nutritional Status of Institutionalised Elderly Filipinos

Introduction: Increasingly, the threat of malnutrition in geriatric institutions is affected by several factors such as cognition, immobility, oral problems, and psychological status. Low food intake is seen to be the primary cause of geriatric malnutrition. Further, greater length of stay and higher physical activity were significantly associated with reduced body weight and good health status, respectively. This study aimed to identify how nutritional quality of meals, food intake, physical activity and length of stay affect the nutritional status of institutionalised elderly in the Philippines. Methods: Data for this study were obtained using food weighing records, 24-hour food recall, Physical Activity Scale for Elderly (PASE), and Mini Nutritional Assessment (MNA) among 100 purposively recruited institutionalised elderly. Macronutrients were computed based on the Philippine Food Composition Table (FCT) while adequacy was evaluated based on the Philippine Dietary Reference Intake (PDRI). Results: The use of Partial Least Square (PLS) regression analysis revealed that of the variables, only food intake (ß=0.17; p=0.04), physical activity (ß=0.16; p=0.04) and length of stay of elderly in the institution (ß=0.18; p<.01) had a weak positive effect on the nutritional status of the institutionalised elderly. Conclusion: This study showed the role of food intake, physical activity and length of stay in the nutritional status of elderly in home care settings. This implies that assessment of the nutritional status and its associated factors remains vital in the development of nutrition intervention and the provision of quality food planning and service in institutionalised settings.

Duración de días de hospitalización psiquiátrica en pacientes con diagnósticos GES con y sin comorbilidades / Length of stay in psychiatric hospitalization in patients with GES diagnoses and its comorbidities

There are several descriptive studies of the use of mental health Services in the population served in the public system, however there are few references concerning the private system. Objective: To characterize a population with GES mental health pathology admitted in private mental health system in relation to the length of stay. Material and Methods: Medical charts were reviewed for 1,544 patients discharged from hospital admissions in private mental health centers. The following variables were recorded: age at diagnosis, sex, length of stay, number of hospitalizations and multiaxial diagnosis. Results: The average hospital stay for the sample was 21.05 days. The average hospital stay of men was 3.71 ± 2.46 days more than average women (p = 0.05). The average LOS was higher in younger patients. With regards to axis I, 68.52% of patients had severe major depression, 21.87% bipolar disorder in severe depressive phase and 6.87% schizophrenia. Axis I comorbidity was present in 17.94% of the sample. For Axis II, 57.97% of patients had personality disorders, with the borderline personality being the most frequent in both sexes (51.06% of patients with disorder of personality). The analysis of information shows that comorbidities did not significantly influence average days of hospitalization. Conclusions: This study is contributes to estimate the costs and the average stay in inpatient GES mental health patients in the private system.

Existen diversos estudios descriptivos del uso de servicios de Salud Mental en la población atendida en el sistema público, sin embargo, se encuentran pocas referencias respecto al sistema privado. Objetivo: Caracterizar a una población con patología de salud mental GES internada en centros privados de salud mental en relación a los días de hospitalización. Material y Método: Se revisaron 1.544 fichas de pacientes egresados de hospitalizaciones en centros privados de salud mental registrando las siguientes variables: edad al momento del diagnóstico, sexo, días de hospitalización, número de hospitalizaciones y diagnóstico según eje. Resultados: El promedio de días de hospitalización de la muestra fue de 21,05 días. El promedio de días de hospitalización de los hombres fue 3,71 ± 2,46 días mayor que el promedio de las mujeres (p = 0,05). El promedio de días de hospitalización fue más alto en los pacientes jóvenes. En el eje I, el 68,52% de los pacientes presentaron patología del ánimo en su forma monopolar; 21,76% patología del ánimo en su forma bipolar y un 6,87% fueron diagnosticados con esquizofrenia. La comorbilidad en el eje I se presentó en un 17,94% de la muestra. Respecto al eje II, el 57,97% presenta algún trastorno de la personalidad, siendo el trastorno de personalidad limítrofe el más frecuente en ambos sexos (51,06% del total de pacientes con trastorno de la personalidad). Del análisis de la información destaca que las comorbilidades no influyeron de forma significativa en el promedio de los días de hospitalización. Conclusiones: Este estudio constituye un aporte para estimar los costos y la estadía promedio en una hospitalización de pacientes GES de salud mental en el sistema privado.

Development of Secondary Order System for Laboratory Tests without Additional Blood Sampling / 대한진단검사의학회지

BACKGROUND: Additional tests ordered by doctors after checking abnormal routine test results for inpatients are usually delayed for one day or more, which in turn delays diagnostic and therapeutic procedures and prolongs length of stay (LOS) for the patients. We at Department of Laboratory Medicine, Asan Medical Center (AMC), established a "secondary order system for laboratory tests without additional blood sampling" to improve the conventional reflexive tests. METHODS: Oracle 8.0 (Oracle Co., Belmont, CA, USA) was used for data base software and Powerbuilder (Powersoft, Burlington, UK) for client development tool. Specimens subjected to "reflexive tests by doctors without additional blood sampling" were SST tubes for routine chemistry and EDTA for routine hematology requested in the morning of additional requests of the laboratory tests. RESULTS: Programs of registration and request for "reflexive tests by doctors without additional blood sampling" and bar code printing were developed for clinicians to check the routine test results and to order additional tests, if necessary, and for laboratory to perform the requested tests using the same samples used for routine chemistry and hematology tests in the morning. Additionally requested tests were done by finding the SST and EDTA samples, putting newly printed bar code, and processing them as usual. In February 2004, right after introducing reflexive tests by doctors without additional blood sampling, 75 additional requests were made for 50 patients, but they increased gradually up to 1,020 tests for 698 patients in December 2004. In 2005, the monthly average number of tests was 1,035 for 742 patients. CONCLUSIONS: The reflexive tests by doctors without additional blood sampling developed at AMC helped establish a rapid reporting of test results, which in turn reduced LOS related to laboratory. It also increased patient satisfactory indices by reducing repeated blood sampling and would also contribute to the financial health of the hospital.