Factors associated with prolonged length of stay in older patients
Singapore medical journal
; : 134-138, 2017.
Article
in English
| WPRIM (Western Pacific)
| ID: wpr-304131
Responsible library:
WPRO
ABSTRACT
<p><b>INTRODUCTION</b>Prolonged stay in acute hospitals increases the risk of hospital-acquired infections in older patients, and disrupts patient flow and access to care due to bed shortages. We aimed to investigate the factors associated with prolonged length of stay (pLOS) among older patients (aged ≥ 78 years) in a tertiary hospital, to identify the potentially modifiable risk factors that could direct interventions to reduce length of stay (LOS).</p><p><b>METHODS</b>During a three-month period from January 2013 to March 2013, we identified 72 patients with pLOS (LOS ≥ 21 days) and compared their demographic and clinical variables with that of 281 randomly selected control patients (LOS < 21 days) using univariate and multivariate logistic regression analyses.</p><p><b>RESULTS</b>The mean age of the patients was 85.30 ± 5.34 years; 54% of them were female and 72% were of Chinese ethnicity. Logistic regression revealed the following significant factors for increased LOS discharge to intermediate and long-term care services (odds ratio [OR] 9.22, 95% confidence interval [CI] 3.56-23.89; p < 0.001); increased severity of illness (OR 2.41, 95% CI 1.12-5.21; p = 0.025); and presence of caregiver stress (OR 3.85, 95% CI 1.67-8.91; p = 0.002).</p><p><b>CONCLUSION</b>Presence of caregiver stress and nursing home placement are potential modifiable risk factors of pLOS among older patients. Early identification and management of caregiver stress, as well as expediting discharge planning, may help to reduce the length of stay for this cohort.</p>
Full text:
Available
Health context:
SDG3 - Target 3.8 Achieve universal access to health
/
SDG3 - Health and Well-Being
Health problem:
Delivery Arrangements
/
Multisectoral Coordination
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Target 3.8 Achieve universal access to health
Database:
WPRIM (Western Pacific)
Main subject:
Singapore
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Social Class
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Stress, Psychological
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Severity of Illness Index
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Random Allocation
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Cross Infection
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Epidemiology
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Regression Analysis
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Risk Factors
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Caregivers
Type of study:
Controlled clinical trial
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Diagnostic study
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Etiology study
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Prognostic study
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Risk factors
Aspects:
Social determinants of health
Limits:
Aged
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Aged, 80 and over
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Female
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Humans
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Male
Country/Region as subject:
Asia
Language:
English
Journal:
Singapore medical journal
Year:
2017
Document type:
Article