Abstract
Introduction
Gorseinon Hospital (GH) is a community rehabilitation facility which offers reablement following an acute admission to hospital. Patients are accepted from both medical and surgical specialty wards. Between 2015-2019 GH had median length of stay (LOS) 32 days. In 2018, 81% of patients returned to their own homes.
Methodology
A retrospective review of all admissions to GH from January to December 2021 (n= 256) to identify opportunities for service improvement.
Results
Median GH LOS was 53 days. Patients transferred from acute frailty and stroke services who received early Comprehensive Geriatric Assessment (CGA) were considered as a separate subgroup; this group (r-CGA) was compared to patients who did not receive early CGA (nr-CGA). The median overall LOS for group nr-CGA is 56 days vs r-CGA median of 51.5 days (Z = -2.591, p < 0.05). 18% of patients returned to the acute hospital. A detailed analysis showed 32.26% patients from general surgical wards returned to hospital. While the proportion of patients in the r-CGA group who returned to hospital was 16.33% and group nr-CGA 18.6%. Median LOS for COVID-19 positive patients was 79 days vs 52 days (p < 0.01). 66% of patients returned home; 13% were discharged to institutional care.
Conclusion
Patients were observed to have a longer length of stay at GH and an increased risk of being discharged to institutional care. Deconditioning associated with hospitalisation, Covid-19 infection and the lockdown periods enforced by the pandemic are potential factors. Early implementation of CGA is likely to reduce acute hospital returns and overall LOS.