“Social service cases” admitted in an Internal Medicine Department: characterization of a special population

Abstract

Background: Prolonged hospital stay after discharge because
of social problems, especially in elderly patients, is an everyday
reality for acute care hospitals.

Objectives: The aim of this study
was to determine demographic and clinical features of all “social
service cases” who were hospitalized in our internal medicine
ward and to evaluating the impact of prolonged hospitalization on
total length of hospital stay.

Patients and Methods: A retrospective
analysis of charts was conducted of all “social service cases” who
were hospitalized in our department of Medicine between January
and December de 2008. Results: We included 120 patients with
a mean age of 75.7 years and equal gender distribution. The
majority of patients lived accompanied at the time of admission.
A quarter of patients had a medical history of ischemic stroke.
The frequency of bedridden state, before admission, was 19.2%.
Acute ischemic stroke was the commonest primary diagnosis. The
mean length of hospital stay was 15 days and increased to 23
days for nonmedical reasons (social problems). At discharge the
majority of patients presented a high degree of dependency for
basic activities of daily living. Thirty four patients were discharged
to “Rede Nacional de Cuidados Continuados Integrados” [National Network for Integrated Continuous Care].

Conclusion: Acute care
hospitals must prepare themselves for the needs of an ageing
population. Functional decline among hospitalized patients is common, and often a major obstacle in the reintegration into society.