Abstract
Considering the large number of elderly patients in acute hospitals who receive medical as well as psychiatric treatment because of relevant comorbidity, adequate interdisciplinary treatment models have to be developed and applied. The Centre for Elderly, a cooperation project between the departments of geriatric and psychogeriatric medicine in a community hospital in Germany, was founded in 2000. In addition to traditionally structured units, the centre consists of interdisciplinary units. Patient-, staff- and hospital-related characteristics influenced by the reformation of both departments were evaluated by comparing hospitalbased registry data records containing age, gender, main and minor diagnoses, length of stay and patient transferrals within the centre. Experts working at the centre were asked to take a stand on the development of the treatment quality, allocation of patients, diagnostic procedures, consultation services and information transmission.
The number of admissions to the Centre for the Elderly increased within one year. The distribution of the main diagnose groups remained unchanged, with an overlap between the geriatric and psychogeriatric department consisting of the main diagnoses dementia and depression. The length of stay and the number of transferrals decreased significantly in both departments. The majority of the interviewed employees stated that the treatment quality and the allocation of patients were improved.
We conclude that interdisciplinary treatment between the departments of psychiatry and geriatric medicine may contribute to the medical needs of subgroups of elderly inpatients suffering from medical-psychiatric comorbidity.
Zusammenfassung
In Anbetracht der hohen Anzahl älterer Patienten in Akutkrankenhäusern, die sowohl somatische als auch psychiatrische Behandlung auf Grund relevanter Co-Morbiditäten benötigen, ist die Entwicklung adäquater interdisziplinärer Behandlungsmodelle notwendig. Das Zentrum für Ältere, ein Kooperationsmodell zwischen den Abteilungen für Geriatrie und für Gerontopsychiatrie in einem kommunalen Krankenhaus in Deutschland, wurde 2000 gegründet. Neben den traditionellen Stationen betreibt das Zentrum ebenfalls interdisziplinäre Stationen. Die Evaluation des Zentrums nutzte Patienten-, Mitarbeiter- und Krankenhaus-bezogene Kenndaten, die durch die Umstrukturierung der beiden Abteilungen beeinflusst wurden. Datensätze des Krankenhausregisters, welche Alter, Geschlecht, Hauptund Nebendiagnosen, Länge der Aufnahme und Verlegungen innerhalb des Zentrums umfassten, wurden verglichen. Mitarbeiter des Zentrums wurden hinsichtlich der Behandlungsqualität, Patientenzuweisung, diagnostischer Abläufe, interdisziplinärer Absprachen und Informationsfluss befragt.
Die Anzahl der Einweisungen in das Zentrum für Ältere nahm innerhalb eines Jahres zu. Die Verteilung der Hauptdiagnosen blieb unverändert mit einem aus den Hauptdiagnosen Demenz und Depression bestehendem Überschneidungsbereich zwischen der geriatrischen und gerontopsychiatrischen Abteilung. Die Verweildauer und die Anzahl der Verlegungen sank signifikant in beiden Abteilungen. Die Mehrzahl der interviewten Mitarbeiter gab an, dass die Behandlungsqualität und die Zuweisung der Patienten verbessert seien.
Insgesamt konnte durch die Zentrumsbildung ein Verbund hergestellt werden, der unserer Auffassung nach den Bedürfnissen somatisch und psychiatrisch Alterskranker entgegenkommt.
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Maier, A.B., Wächtler, C. & Hofmann, W. Combined medical-psychiatric inpatient units. Z Gerontol Geriat 40, 268–274 (2007). https://doi.org/10.1007/s00391-007-0432-8
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DOI: https://doi.org/10.1007/s00391-007-0432-8