227 unscheduled acute hospital admissions from a community rehabilitation team – geriatric giants or “acopia”?

Abstract Background The Integrated Care Team (founded 2018) provides community rehabilitation in the home for frail older adults. Frail older adults are at increased risk of hospitalisation, and frailty is associated with increased length of stay and mortality. This retrospective cohort study aims to explore the acute hospital admissions of this frail cohort from July 2019 to December 2021. Methods Patients were identified from the integrated care team database who had a discharge destination of “Acute Hospital”. Hospital IT system data and discharge summaries were used to analyse inpatient Length of Stay (LOS), presenting complaints and discharge diagnosis. The study period was from July 2019 to December 2021. Results 67 patients were admitted to hospital during the study period from the care of the integrated care team, accounting for 98 individual hospital admissions. This accounted for 19.8% of discharges from the team during the study period, with 77% of patients discharged to community support. 23.8% of patients (n=16) had multiple admissions, with the majority of these(n=14) admitted twice. The average age of patients was 82.6 years. 58% of admitted patients were female. The longest LOS was 99 days, and shortest less than one day. The average LOS was 12.9 days for the total population. Excluding two outlier stays of 99 and 82 days, the average LOS was 11.27 days. 32% of patients presented with functional decline, 28% with falls, 18% with shortness of breath and 19% with delirium. Infections were diagnosed in 28% of patients, neurological events in 12% and bleeding diagnoses in 11% of patients. 1 patient died during admission. Only 12.2% of stays (n=12) were less than 72 hours in duration. Conclusion This frail patient cohort presented with a range of frailty syndromes and complications of medical comorbidities. The low prevalence of short hospital stays may reflect the ongoing role of the community team supporting patients in the community.