Table 1.
Description and/or instrument | H1 | H2 | P1 | P3 | P6 | |
1. Medical and demographical data | ||||||
Sociodemographic data | Date of birth, age at admission, sex, level of education, living conditions, marital status | R | ||||
Data on admission | Time spent at the ED, admission diagnosis, date and time of admission | R | ||||
Chronic conditions | Charlson Comorbidity Index39 | R | ||||
Polypharmacy | Number of drugs | R | ||||
Mortality | Date of death | R | R | R | R | |
2. Cognitive functioning | ||||||
Cognitive impairment | Mini-Mental State Examination31 | R | ||||
Delirium | Safety management system patient screening (VMS)42 Confusion Assessment Method40 Delirium Observation Scale43 |
N/D | N/D | |||
3. Psychosocial functioning and quality of life | ||||||
Apathy | Geriatric Depression Scale44 | N | R | R | R | R |
Social network and informal care | Presence and frequency of informal care | R | R | R | R | |
Quality of life and health status | EQ-5D37 | R | R | R | R | |
4. Physical functioning | ||||||
Identifying at-risk-patients | ISAR-HP—Identifying Seniors at Risk score45 | N | ||||
Functional status | Activities of Daily Living (ADL) modified Katz-ADL score36 | N | ||||
(Im)mobility | Using a walking aid, information from the Katz-ADL questions on exercise | N | ||||
Handgrip strength | Jamar49 | P | ||||
Gait speed | Short Physical Performance Battery50 | P | ||||
Falling | Fall history Falls in the AGCH Numeric Rating Scale (NRS) on the fear of falling35 |
N N |
R R |
R R |
R R |
R R |
Pain | NRS on pain51 | N | R | R | R | R |
Fatigue | NRS on fatigue52 | N | R | R | R | R |
Nutrition | Short Nutritional Assessment Questionnaire53 | N | ||||
5. Healthcare utilisation and satisfaction with care | ||||||
Medical care during admission | Diagnostics performed in the AGCH Readmission to university hospital Length of stay at the AGCH |
R | ||||
Hospital readmission | Readmission rate to the hospital or AGCH | R | R | R | R | |
Healthcare utilisation | Home care, medical specialist care, temporary institutional care, primary care | R | R | R | R | |
Satisfaction with care | 8-question questionnaire54 | R | (R)* |
*In case the assessment was missed at H2.
AGCH, Acute Geriatric Community Care Hospital; D, Doctor/attending physician; ED, emergency department; EQ-5D, EuroQoL-5D; H1, at admission; H2, at discharge; ISAR-HP, Identification of Seniors at Risk-Hospitalized Patients; N, nurse; P1, one month after discharge; P3, three months after discharge; P6, six months after discharge; P, physiotherapist; R, researcher/research nurse.