Post Hospital Sub Acute Care: A New Model Of Caring Through Geriatric Methodology

Introduction. The Sub Acute Care Units (UCSA) are units with low diagnostic intensiveness, aimed to continue medical treatment after hospitalization, for clinical recovery and restoration of premorbid functional and cognitive functions.Objectives. Evaluate the effectiveness of an UCSA respect to specific outcomes: a) clinical cure, b) cognitive and psychological revaluation, c) functional reactivation, e) protected discharge at home.Methods. In the UCSA at Hospital and Foundation Poliambulanza of Brescia - 310 patients were admitted in 2011: clinical, cognitive, functional and social goals were identified after a clinical evaluation and multidimensional geriatric assessment.Results. Patients were very old, with low schooling, predominantly female and with social problems; they also showed mild cognitive impairment, moderate functional dependence and frailty: clinical conditions such as delirium and depression are frequent. During the hospitalization, 52% did not experience an intercurrent event, 30% experience an acute event. At discharge there was an overall improvement in clinical, cognitive and functional performance; 64% of patients return to home.Conclusions. Data show that, in an area of lower intensity care, of elderly patients can be effectively treated reaching a comprehensive recovery, and the achievement in "strong" outcomes (clinical cure, cognitive and functional recovery, return to the home). The model "UCSA-Geriatrics" is an integration of specific needs, using multidimensional and multidisciplinary geriatric approach to improve functional outcomes.