Introduction
Patients admitted under the Geriatric Evaluation and Management in The Home (GEMITH) program receive multidisciplinary medical and allied health team input at home as an extension of their inpatient admission to allow for reduced hospital length of stay (LOS) and further optimisation in the community to reduce risk of hospital representations.
This study aims to evaluate the characteristics of patients who had hospital readmissions while under GEMITH program.
Methods
Medical charts were reviewed of all patients that represented to hospital while under the GEMITH program between August and September 2022. Patients with readmissions were identified based on hospital coding and electronic medical records (iEMR).
Results
A total of 122 patients were admitted under GEMITH between August and September 2022. Of those, 19% of patients (mean age 84 ± 6.8 years) had hospital representations. Ten patients (43%) were females. 83% of these representations were due to acute medical illness. The remaining 17% were due to carer stress or failed independent living; most of these patients had anticipated high care needs and were discharged for trial of home to assess sustainability of ongoing independent living.
Patients who had readmissions had an average LOS of 10 ± 8 days prior to commencing GEMITH program. Average duration under GEMITH was 6 ± 6 days prior to readmission. The average readmission LOS was 8 ± 8 days. Post readmission, 39% of patients were readmitted onto GEMITH; 48% did not require further GEMITH input on discharge. One patient was discharged to respite. Two patients passed away in hospital.
Conclusion
Representations are expected in a small proportion of patients given high-risk discharges are part of the GEMITH patient demographics. Most representations were due to acute medical illness, the remainder due to failed independent living. Increased inpatient length of stay during both admission and readmission could reflect the increased medical and social complexity in this cohort of patients. Careful selection of patients to ensure medical stability could potentially reduce the number of representations.