Background and purpose of the study: protected hospital discharge (PD) is a great resource for fragile patients (pts) and their families after stay in acute ward hospital. We study characteristics of this population and the most common diseases.   

Materials and methods: we propose a dashboard of severity indicators to assess pts discharged in two years of activity 2014-2015 from internal medicine of Cuggiono: age, re-admissions and death within 30 days of discarge, welfare index, oxigen therapy, infections from Clostridium difficile, multi-resistant infections, disfagia, aspiration pneumonia, hearth failure. We don’t include terminal pts with neoplasia followed by home service of palliative care.

Results: we organized 93+90 PD (in 2014-15 respectively), 71+61 women, 22+29 men of 915+942 total hospitalizations. Mean age 85.82-85.21 (vs 77.99 all pts hospitalized), average hospital stay 13.2-15.58 days (vs 9.6-9.1), re-admissions 17/93-29/90 (vs 97/915-54/942), 30/93-24/90 deaths within 30 days of discharge, welfare index was 4 (completely dependent for all the functions of life) in 89/93-84/90. Oxygen therapy 26/93-13/90 (vs 53/915-35/942), nasogastric tube 17/93-14/90, infections from Clostridium difficile 21/93-6/90, multi-resistant infections 28/93-13/90. Aspiration pneumonia and heart failure were the most common causes of death and output diagnosis 27/93-24/90 for aspiration pneumonia and 26/93-19/90 for heart failure.

Conclusions: the indicators considered well express the severity of pts discharged especially with regard to aspiration pneumonia and heart failure.