תוצאת חיפוש

Prevalence Rate, Place of Hospitalization and Source of Referral of Complex Nursing Care Patients in Geriatric Hospitalization

Netta Bentur, Jenny Brodsky, Beni Habot

JDC-Brookdale Institute of Gerontology and Human Development, Jerusalem; Shmuel Harofeh Geriatric Medical Center; Rishon Lezion Geriatric Center; and Sackler Faculty of Medicine, Tel Aviv University

For the past several years, the hospitalization and care of complex nursing care patients (CNCP) has caused concern among organizers, funders and care-givers of the geriatric hospitalization system (GHS). To assist in improving efficiency of the GHS and to address the lack of comprehensive, empirical and up-to-date information on these patients, we conducted a survey to characterize CNCP, to assess their medical problems and to determine their prevalence among the patients in GHS. The survey was conducted in 1994 using a day census. Data were collected on the 2,319 patients in geriatric beds in all the general hospitals and geriatric hospitals in Israel on the day of the survey.

28% of the patients in the GHS were CNCP and a quarter of them (7% of all patients) suffered from more than 1 medical condition. Tube feeding was the most prevalent condition (13% of all patients), followed by terminal illness (9%), deep pressure sores (7%) and intravenous transfusion for more than 3 days (6%). The 80% of the CNCP were hospitalized in geriatric hospitals, primarily in geriatric rehabilitation wards. Their average length of stay was over a year. Internal medicine wards of general hospitals were the most frequent source of patient referral. The survey's findings raise issues related to the organization of care of CNCP. They may serve as a basis for the reorganization of the geriatric hospitalization system in order to improve efficiency and quality of care for the benefit of patients, their families and services providers.

The Homeless and The Health System: Profile of the Homeless Patient

J. Posen, N. Tanai, S. Spiro, D. Frumer

Social Work Dept., Ichilov Hospital, Tel Aviv and Faculty of Social Work, Tel Aviv University

The homeless population is mobile and does not use ambulatory health care services. Thus the major contact between the homeless and the medical establishment occurs primarily when they are treated for acute symptoms in hospital. We describe the clinical and sociodemographic profile of the homeless who require hospital services. The research population included 50 homeless treated in the emergency room and various departments of our medical center between October 1994 and August 1995. Social workers used a questionnaire relating to clinical, sociodemographic and social factors. Most patients were men, 76% under the age of 50. The most common diagnosis was alcoholism; other diagnoses included back, limb and joint injuries, infections, skin diseases, and general exhaustion. There were subgroups with differing needs within this homeless population for which appropriate rehabilitation programs are proposed.