Incidence of short-term community hospital stays and clinical profiles of patients: the Finnish Community Hospital Cohort Study.

OBJECTIVE: A community hospital system covers the entire population of Finland. Yet there is little research on the system beyond routine statistics. More knowledge is needed on the incidence of hospital stays and patient profiles. We investigated the incidence of short-term community hospital stays and the features of care and patients. DESIGN: Prospective observational study. SETTING: Community hospitals in the catchment area of Kuopio University Hospital in Finland. SUBJECTS: Short-term (up to one month) community hospital stays of adult residents. MAIN OUTCOME MEASURES: The outcome was the incidence rate of short-term community hospital stays according to age, sex and the first underlying diagnoses. RESULTS: A number of 13,482 short-term community hospital stays were analyzed. The patients' mean age was 77 years. The incidence rate of short-term hospital stays was 28.6 stays per 1000 person-years among residents aged <75 years and 419.0 among residents aged ≥75 years. In men aged <75 years, the hospital stay incidence was about 40% higher than in women of the same age but in residents aged ≥75 years incidences did not differ between sexes. The most common diagnostic categories were vascular and respiratory diseases, injuries and mental illnesses. CONCLUSIONS: The incidence rate of short-term community hospital stays increased sharply with age and was highest among women aged ≥75 years. Care was required for acute and chronic conditions common in older adults. IMPLICATIONS: Community hospitals have a substantial role in hospital care of older adults.

Finland has a broad network of community hospitals covering the entire population. More knowledge is needed on incidences and patient profiles of community hospital stays.The incidence of short-term community hospital stays increased sharply with age and was the highest among women aged ≥75 years.Vascular and respiratory diseases accounted for most of the community hospital admissions.Community hospitals play an important role in the care of an aging population.

Factors Associated With Discharge Destination in Older Patients: Finnish Community Hospital Cohort Study.

OBJECTIVES: Primary care physician-led community hospitals provide basic hospital care for older people in Finland. Yet little is known of the outcomes of the care. We investigated factors associated with discharge destination after hospitalization in a community hospital and the role of active rehabilitation during the stay. DESIGN: Prospective observational study. SETTING AND PARTICIPANTS: Short-term community hospital stays of older adults (≥65 years) living in the Kuopio University Hospital district in central and eastern Finland. METHODS: Data on short-term (1-31 days) hospital stays from 51 community hospitals were collected with an electronic survey between January and June 2016. Physicians, secretaries, and rehabilitation staff from each community hospital completed the data collection form. Discharge destination was defined as home, residential care or death, and active rehabilitation as frequency of rehabilitation at least once a day. Analyses were conducted using the Bayesian approach and the BayesiaLab 9.1 tool. RESULTS: Data of 11,628 community hospital stays were analyzed. The patients' mean age was 81.6 years (SD 7.9), and 57.5% were women. A younger age (65-74 years), a high number of rehabilitation staff (>2 per 10 patients), and receiving rehabilitation at least once a day were associated with discharging patients to their own homes. Daily rehabilitation was associated with returning to home in all patient groups. CONCLUSIONS AND IMPLICATIONS: Older patients admitted to a community hospital for any reason may benefit from active rehabilitation. The role of community hospitals in the acute care and rehabilitation of older patients is important in aging societies.