Anna García-Altés, Head of the Catalan Health System Observatory
This report presents the results of all SISCAT long-term care centres for 2014. This year, the structure of the report is slightly different from previous years. It deals with fewer topics but in a more concrete in-depth manner. Similarly to last year, the results emerging from the information provided by the basic minimum acute hospitalization data sets and long-term care resources are presented which allows us to evaluate the coordination between care levels and early referral to a convalescent care centre. The tables with the values of all indicators centre by centre -the distinguishing feature of the Results Centre- remain. As in previous years, all reports include innovative experiences that provide good care results, included in the Observatori d’Innovació en Gestió de la Sanitat in Catalonia as well as the experts’ opinions.
In 2014 a quarter of the activity of long-term care hospitalization corresponds to diagnoses of femoral neck fracture, stroke, congestive heart failure and chronic obstructive pulmonary disease. Seven out of ten patients admitted for these diagnoses are treated in convalescent care units, where they account for 29.5% of total activity. The coordination among healthcare levels promotes early referral to a convalescent resource and early initiation of rehabilitation, especially in convalescent care units. The lenght of stay of people with a fractured neck of femur derived from hospital to a long-term care service has been 10 days for an acute care hospital and 41 days for a convalescent care unit; for stroke, stays are 12 days in the acute care hospitals and 41 days in convalescent care units. The percentage of people who have improved their functional status during hospitalization in a convalescent care resource has been 43.9%, and the percentage of people discharged at home is 69.3% (in the particular case of femur fracture is 76.6%).
In 2014, 6 of every 10 deaths in palliative care units and in palliative care at home (PADES) were diagnosed with cancer; this ratio is 21.5% in long-term care, 12.3% in convalescent care resources and 44.9% in geriatric units. The average length of stay of people who die in palliative care units is 6 days and 8 days in the case of cancer patients; in the case of PADES teams it is 34 days in total treated patients, and 42 days in the case of cancer patients.
During 2014, delusions, dementia and other amnesic and cognitive disorders were the primary diagnosis for 32% of day geriatric hospitalisations episodes and for 16% of the long-term hospitalizations. The average stay of these persons exceeds 210 days in both types of resources. The Balance Centre indicators of SISCAT long-term care entities for 2013 concerning admissions with good outcomes, economic profitability, positive generated resources and admissions per unit of output have worsened slightly, while the cost per unit of output and productivity improved compared with 2012. The solvency has improved and the debt has decreased compared to 2012.
As in previous years, the analysis of the results of this report can be deepened through the Results Centre’s applicative and the dynamic calculation sheets available on the Observatory’s website (http: //observatorisalut.gencat.cat), as well as through open data files that, while meeting W3C international standards, are available to all on the Generalitat de Catalunya website (http://dadesobertes.gencat.cat/ca). Finally, similarly to last year, a summary of the results in the form of an info-graphic has been published.
This report, and all the presented data, can be found on the Observatory website: http://observatorisalut.gencat.cat