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British Medical Journal (Clinical research ed.) (1)
CME journal. Geriatric medicine (1)
Journal of the Royal Society of Medicine (1)
Briggs, Roger (3)
Allen, Stephen C (1)
Cooper, Cyrus (1)
Cox, Vanessa (1)
Lowrey, Sue (1)
Sayer, Avan Aihie (1)
Sharma, Jagdish C (1)
Syddall, Holly E (1)
Ugboma, Ike (1)
Vassallo, Michael (1)
Vignaraja, Raj (1)
Year of Publication
Coding Geriatric syndromes: How good are we?
Syddall, Holly E
Sayer, Avan Aihie
CME journal. Geriatric medicine
High quality coding of hospital activity is important because the data is used for resource allocation and measuring performance. There is little information on the quality of coding of admissions of frail older people who have multiple diagnoses, co-morbidities and functional impairment. Presence or absence of four geriatric syndromes and eight medical conditions was noted on case note review (CNR). Discharge summaries (DS) and hospital coding (HC) were reviewed and compared with the CNR. Forty patients had at least one geriatric syndrome noted in the DS; 16 (40.0%) were captured by the HC. Of 57 patients with at least one medical condition noted in the DS, 52 (91.2%) were captured by the HC (p<0.0001 for difference in HC capture rates). We have demonstrated poor capture of information on geriatric syndromes compared to medical conditions in discharge summaries and hospital coding and propose a problem list bookmark approach to improve this.
Coding; routine data; geriatric syndromes; frailty
Predictors for falls among hospital inpatients with impaired mobility
Sharma, Jagdish C
Allen, Stephen C
Journal of the Royal Society of Medicine
Gait and balance disturbances have been shown to predispose to falls in hospital. We aimed to investigate the patient characteristics associated with an unsafe gait and to determine what features predispose to falling in this group of hospital inpatients. In a prospective open observational study we studied 825 patients admitted for rehabilitation following acute medical illness or a surgical procedure. The patient's gait was assessed with the ‘get up and go’ test and classified into one of four categories—normal; abnormal but safe with or without mobility aids; unsafe; or unable.
72.6% of patients were assessed as having an unsafe gait. The factors independently associated with an unsafe gait were confusion, abnormal lower limbs, hearing defects and the use of tranquillizers. Patients with an unsafe gait who fell were more likely than the non-fallers within the group to have had falls in the past (85.3% versus 73.8%) and to be confused (66.2% versus 34.1%). Patients with both these characteristics had a 37.5% chance of falling compared with 15.4% in patients with one and 11.2% in patients with none of these characteristics.
The presence of confusion and a history of falls identifies those patients who are at greatest risk of falls. Such patients might be the focus of special efforts at falls prevention.
Boom in private rest homes in Southampton: impact on the elderly in residential care
British Medical Journal (Clinical research ed.)
A survey in 1986 of 450 elderly people in 51 private rest homes and 206 residents of seven local authority (part III) homes in the Southampton area showed no significant difference in overall dependency between the two populations. Although age and sex distributions of the residents of part III homes had remained the same between 1982 and 1986, the average level of dependency had fallen significantly. Since the provision of places increased because of expansion in the private sector residential care institutions are generally catering for a more independent population.
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