Letters Preventing admission of older people

Preventive care programmes keep people active and independent for longer

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f4874 (Published 06 August 2013) Cite this as: BMJ 2013;347:f4874
  1. A J Tulloch, retired general practitioner1,
  2. D L Beales, retired general practitioner
  1. 1Wendlebury, UK
  1. aj.tulloch{at}btinternet.com

We contest D’Souza and Guptha’s claim that “no convincing evidence exists that increases in the provision of community services reduce the length of stay for frail older people.”1

There are two commonly used markers of the effectiveness of such programmes in older patients—the number of institutional referrals and time spent in institutional care. The ultimate objective of care in this field is to keep these vulnerable old people active and independent for as long as possible. Thus, the effectiveness of these measures is best reflected by reductions in the number of bed days of institutional care rather than the number of institutional referrals.

The authors …

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