Research Abstract: Free Paper - Poster Presentation Only Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2023

Relationship between casemix from Residential in Reach (RIR) program and the average Length of Stay (LOS) under Hospital in the Home (HITH) (#152)

Bing Chang 1 , Angela Zeng 1 , Seok Lim 1 2 , Henry Yao 1
  1. RMH@Home, Royal Melbourne Hospital, Parkville, Victoria, Australia
  2. Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia

Aims 

RIR services aim to reduce avoidable emergency presentations by providing timely acute supports to Residential Aged Care Facilities (RACFs). If ongoing acute treatments are required, the RIR team refers on to HITH for admission and ongoing management, thereby avoiding a hospital presentation.  

This study aims to gain insights into the types of referrals from RIR into HITH, and evaluate the average LOS with respect to the referral condition.  

 

Methods 

Retrospective audit conducted within a Melbourne tertiary teaching hospital between May – July 2022.  

Information collected included baseline demographics, reason for referral, and the average LOS.  

 

Results  

During May – July 2022, there were 169 number of referrals to HITH. The highest proportion of referrals were for Respiratory infections(n=40), followed by Delirium (n=25) and UTI/IDC-related infections (n=24). 

The average LOS was 7.3 days, with range 3.3 to 14.2 days. The highest average LOS was noted in those referred for heart failure, Behavioural and Psychological Symptoms of Dementia (BPSD) and then gastrointestinal illness (14.2, 11 and 8.7 days respectively). 

 

Conclusions 

The higher proportion of respiratory illnesses referred were likely reflective of the winter season, with a shorter LOS likely associated with institution of antimicrobial treatments. 

Cardiac conditions including decompensation of heart failure had the longest LOS due to the challenging nature of fluid balance management in RACF residents.   

A larger study would provide further insights into the utilisation of HITH resources amongst RACF residents to help  guide future workforce planning and resource allocation.