THE BELGIAN GERIATRIC DAY HOSPITALS AS PART OF A CARE PROGRAM FOR THE GERIATRIC PATIENT: FIRST RESULTS OF THE IMPLEMENTATION AT THE NATIONAL LEVEL

Purpose: In order to deliver individual, specialized and multidisciplinary care for older people, the Belgian national health authorities developed the care program for the geriatric patient. In that context, 48 geriatric day hospitals (GDHs) have been financed by the government since January 1(st) 2006. The main objective of this study is to describe the patient characteristics, facility features and activities related to the Belgian GDHs. Methods: A prospective, multicenter study was performed from October 1(st) till December 31(st) 2006 in all 48 GDHs. For each GDH a transversal data collection was carried out. In the same period all patients scheduled for the GDHs were registered and followed for 3 months. Therefore two questionnaires were developed using Filemakers (R) software: one for each GDH and one for each patient. There were no exclusion criteria. Results: Six GDHs did not complete one or both questionnaires. Consequently, the results of 42 GDHs were included. GDHs with more years of activity had significantly more new patient contacts per day. Activities in the Belgian GDHs were mainly diagnostic with emphasis on geriatric syndromes and specific medical problems. The reason for admission to the GDH was often multifactorial. The syndromes that motivated patients 75 or older to visit the GDH were clearly geriatric (mainly cognitive disorders) and represent the principle public health problems in this age category. Despite the legal provision preserving GDHs for patients 75 years or older a quarter of all patients was younger than 75, presenting with a geriatric syndrome. The contribution of the general practitioners was limited. Conclusions: Activities in the Belgian GDHs are mainly diagnostic with emphasis on geriatric syndromes (particularly cognitive disorders) and specific medical problems. More information is needed on the knowledge and expectations of general practitioners in order to establish a closer collaboration.