In-hospital morbidity and mortality among patients from residential respite care.

Abstract

Residential respite is an important support for many community-dwelling older Australians and their caregivers. Respite clients are often very frail with high or specific care needs. Little is known about the comparative outcomes of hospital admission between permanent residential aged care facility (RACF) residents and residential respite residents. Retrospective study of residential respite patients admitted to an Australian tertiary hospital between November 2014-September 2017. Comparison groups: all RACF patients admitted during same period (general RACF group), and control group matched (2:1) for aged, gender and diagnosis. In-hospital mortality, hospital length of stay (LOS), in-hospital complications (including fall, delirium, pressure injury, Medical Emergency Team [MET] call). Comparisons adjusted for age, gender, presenting symptom and matching variable. 166 admissions from residential respite and 332 matched RACF controls identified from 4,575 admissions for permanent RACF residents. Mortality was significantly higher in respite group vs general RACF group (15.1% vs 8.2%, p<0.001) but not matched control group (15.1% vs 16.3% p=0.795). LOS was significantly higher in respite patients than either control group. Respite patients had significantly higher prevalence of in-hospital fall (10.8% vs 1.5% p <0.0001) and delirium (35.5% vs 17.7% p<0.001) than matched RACF controls. No significant differences were seen in in MET-call and pressure injury rates. While residential respite recipients represent a minority of total residential aged care admissions, they are at high risk of poor outcomes. Prospective identification and timely intervention may improve quality of care for this vulnerable cohort. This article is protected by copyright. All rights reserved.