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PubMedDate not supplied

General hospital resources consumed by an elderly population awaiting long-term care.

The provision of extended care facilities in urban Ireland has lagged behind the growth in the numbers of older people. A final pathway for placement is often through the general hospital and the attendant delay results in a diversion of resources. We developed a database of the long-term care waiting lists for the years 1994-present and this was analysed for the six years 1994-1999. We calculated the number of bed-days consumed by elderly patients awaiting placement in long-term care facilities and thus the hospital resources consumed during these periods. The total number of bed-days consumed over the study period was 51,923, the mean being 8653.8 days. Approximately 23.9% of patients die in hospital while awaiting long-term placement. Translating these bed-days into opportunity cost losses in areas relevant to the general hospital we found that 560 extra elective orthopaedic procedures and 1,212 extra transurethral prostatectomies could have been performed per year. The problem of overnight stays in casualty could have been totally abolished if only 65% of these beds were free. Elective theatre is often cancelled with one of the primary reasons being lack of beds. If even a proportion of these beds could be freed up few if any theatre sessions would have to be cancelled, assuming bed availability to be the only factor. This study confirms that the lack of appropriate accommodation for older people requiring extended care is consuming a significant proportion of health care resources. An accelerated program of building of publicly funded long-term placement facilities is urgently required to ameliorate this problem, especially in the greater Dublin area. Further study is required to determine whether this problem exists in other health board areas and if so whether it exists to the same extent.

Age Distribution↗
PubMed1988

Resolution on Creating Family-Style Children's Homes, August 1988.

This Resolution approves a proposal of the V.I. Lenin Soviet Children's Fund for setting up "family-style" children's homes in the Soviet Union. Children's homes are to consist of a) children's towns--single-family, multiroom homes occupied by families raising at least ten orphaned children and children left without parental care; and b) premises of individual families raising at least five such children while occupying separate multiroom units in regular apartment buildings, specialized buildings, or groups of buildings. In addition to residential buildings, children's towns are to contain a secondary school, a sports and fitness center, preschool facilities, housekeeping and preventative health care buildings, auxiliary farming plots, and other land where children and adults can work together. Thirty homes are to be built in the period 1988-1991. The Resolution also approves proposals establishing an All-Union Wardship Council; charging public health officials with providing permanent, qualified health care, consultation, mental health care, and diagnostics to every family assuming the responsibility of raising children; setting the task of organizing expanded research on children's health and treatment; recommending that enterprises, organizations, and institutions provide transportation service to family-style children's homes and families of employees raising these children and give them passes to sanatoriums, preventoriums, recreation centers and vacation complexes; and pledging the Council of Ministers' participation in the financing, construction, outfitting, and equipping of these homes and in providing material assistance to families raising orphaned children and children left without parental care. The Council of Ministers also decided that the time foster parents spend in raising five or more such children will be added to their overall continuous work record for the purposes of pensions and benefits and to their length of service in their specialty.

Adolescent↗
PubMedDate not supplied

Myriad pieces of facility development, Part 2.

The first article in this series discussed the complexity and breadth of deciding what to do when relocating your practice. Assuming you have accomplished those tasks, you now need to undertake the job of actually getting that done. This section takes you from the conceptualization of the project to the actual heavy lifting, and outlines the concrete (literally) steps that must be taken to bring the undertaking to fruition.

Facility Design and Construction↗