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Published in: BMC Health Services Research 1/2011

Open Access 01-12-2011 | Research article

Acute hospital admissions among nursing home residents: a population-based observational study

Authors: Birgitte Graverholt, Trond Riise, Gro Jamtvedt, Anette H Ranhoff, Kjell Krüger, Monica W Nortvedt

Published in: BMC Health Services Research | Issue 1/2011

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Abstract

Background

Nursing home residents are prone to acute illness due to their high age, underlying illnesses and immobility. We examined the incidence of acute hospital admissions among nursing home residents versus the age-matched community dwelling population in a geographically defined area during a two years period. The hospital stays of the nursing home population are described according to diagnosis, length of stay and mortality. Similar studies have previously not been reported in Scandinavia.

Methods

The acute hospitalisations of the nursing home residents were identified through ambulance records. These were linked to hospital patient records for inclusion of demographics, diagnosis at discharge, length of stay and mortality. Incidence of hospitalisation was calculated based on patient-time at risk.

Results

The annual hospital admission incidence was 0.62 admissions per person-year among the nursing home residents and 0.26 among the community dwellers. In the nursing home population we found that dominant diagnoses were respiratory diseases, falls-related and circulatory diseases, accounting for 55% of the cases. The median length of stay was 3 days (interquartile range = 4). The in-hospital mortality rate was 16% and 30 day mortality after discharge 30%.

Conclusion

Acute hospital admission rate among nursing home residents was high in this Scandinavian setting. The pattern of diagnoses causing the admissions appears to be consistent with previous research. The in-hospital and 30 day mortality rates are high.
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Literature
1.
go back to reference Rechel B, Doyle Y, Grundy EMM: How can health systems respond to population ageing?. Edited by: Permanand G. 2009, WHO Regional Office for Europe and European Observatory on Health Systems and Policies Rechel B, Doyle Y, Grundy EMM: How can health systems respond to population ageing?. Edited by: Permanand G. 2009, WHO Regional Office for Europe and European Observatory on Health Systems and Policies
2.
go back to reference Creditor M: Hazards of Hospitalizations of the Elderly. Annals of Internal Medicine. 1993, 118 (3): 219-223.CrossRefPubMed Creditor M: Hazards of Hospitalizations of the Elderly. Annals of Internal Medicine. 1993, 118 (3): 219-223.CrossRefPubMed
3.
go back to reference Hirsch CH, Sommers L, Olsen A, Mullen L, Winograd CH: The natural history of functional morbidity in hospitalized older patients. Journal of the American Geriatrics Society. 1990, 38 (12): 1296-1303.CrossRefPubMed Hirsch CH, Sommers L, Olsen A, Mullen L, Winograd CH: The natural history of functional morbidity in hospitalized older patients. Journal of the American Geriatrics Society. 1990, 38 (12): 1296-1303.CrossRefPubMed
4.
go back to reference Friedman SM, Mendelson DA, Bingham KW, McCann RM: Hazards of Hospitalization: Residence Prior to Admission Predicts Outcomes. The Gerontologist. 2008, 48 (4): 5.CrossRef Friedman SM, Mendelson DA, Bingham KW, McCann RM: Hazards of Hospitalization: Residence Prior to Admission Predicts Outcomes. The Gerontologist. 2008, 48 (4): 5.CrossRef
5.
go back to reference Report no. 47 (2008-2009) to the Storting: The Coordination Reform: Summary in English 2008-2009. Report no. 47 (2008-2009) to the Storting: The Coordination Reform: Summary in English 2008-2009.
6.
go back to reference Finn JCFL, Mackenzie E, Jacobs IG, Fatovich DM, Brummond S, Harris M, Holman DCDJ, Sprivulis P: Interface between residential aged care facilities and a teaching hospital emergency department in Western Australia. Med J Aust. 2006, 184 (9): 432-435.PubMed Finn JCFL, Mackenzie E, Jacobs IG, Fatovich DM, Brummond S, Harris M, Holman DCDJ, Sprivulis P: Interface between residential aged care facilities and a teaching hospital emergency department in Western Australia. Med J Aust. 2006, 184 (9): 432-435.PubMed
7.
go back to reference Finucane PWR, Whitehead C, Williamson L, Baggoley C: Use of In-patient Hospital Beds by People Living in Residential Care. Gerontology. 2000, 46: 133-138. 10.1159/000022148.CrossRefPubMed Finucane PWR, Whitehead C, Williamson L, Baggoley C: Use of In-patient Hospital Beds by People Living in Residential Care. Gerontology. 2000, 46: 133-138. 10.1159/000022148.CrossRefPubMed
8.
go back to reference Ingarfield SL, Finn JC, Jacobs IG, Gibson NP, D'arcy C, Holman J, Jelinek GLF: Use of emergency departments by older people from residential care: a population based study. Age and Ageing. 2009, 38: 314-318.CrossRefPubMed Ingarfield SL, Finn JC, Jacobs IG, Gibson NP, D'arcy C, Holman J, Jelinek GLF: Use of emergency departments by older people from residential care: a population based study. Age and Ageing. 2009, 38: 314-318.CrossRefPubMed
9.
go back to reference Gruneir A, Bell CM, Bronskill SE, Schull M, Anderson GM, Rochon PA: Frequency and Pattern of Emergency Department Visits by Long-Term Care Residents--A Population-based Study. Journal of the American Geriatrics Society. 2010, 58 (3): 510-517. 10.1111/j.1532-5415.2010.02736.x.CrossRefPubMed Gruneir A, Bell CM, Bronskill SE, Schull M, Anderson GM, Rochon PA: Frequency and Pattern of Emergency Department Visits by Long-Term Care Residents--A Population-based Study. Journal of the American Geriatrics Society. 2010, 58 (3): 510-517. 10.1111/j.1532-5415.2010.02736.x.CrossRefPubMed
10.
go back to reference Jensen PM, Fraser F, Shankardass K, Epstein RJK: Are long-term residents referred appropriately to hospital emergency departments?. Can Fam Physician. 2009, 5 (55): 5. Jensen PM, Fraser F, Shankardass K, Epstein RJK: Are long-term residents referred appropriately to hospital emergency departments?. Can Fam Physician. 2009, 5 (55): 5.
11.
go back to reference Ronald LA, McGregor MJ, McGrail KM, Tate RBAB: Hospitalization Rates of Nursing Home Residents and Community-Dwelling Seniors in British Columbia. Canadian Journal of Aging. 2008, 27: 109-115. 10.3138/cja.27.1.109.CrossRef Ronald LA, McGregor MJ, McGrail KM, Tate RBAB: Hospitalization Rates of Nursing Home Residents and Community-Dwelling Seniors in British Columbia. Canadian Journal of Aging. 2008, 27: 109-115. 10.3138/cja.27.1.109.CrossRef
12.
go back to reference Godden SAMP: The use of acute hospital services by elderly residents of nursing and residential care homes. Health and Social Care in the Community. 2001, 6 (9): 367-374.CrossRef Godden SAMP: The use of acute hospital services by elderly residents of nursing and residential care homes. Health and Social Care in the Community. 2001, 6 (9): 367-374.CrossRef
13.
go back to reference Grabowski DCSK, Broderick SM, Coots LA: Predictors of Nursing Home Hospitalization: A review of the literature. Medical Care Research and Review. 2008, 65 (3): 3-39.PubMed Grabowski DCSK, Broderick SM, Coots LA: Predictors of Nursing Home Hospitalization: A review of the literature. Medical Care Research and Review. 2008, 65 (3): 3-39.PubMed
14.
go back to reference Arendts G, Howard K: The interface between residential aged care and the emergency department: a systematic review. Age and Ageing. 2010, 39: 7.CrossRef Arendts G, Howard K: The interface between residential aged care and the emergency department: a systematic review. Age and Ageing. 2010, 39: 7.CrossRef
15.
go back to reference OECD: Health at a Glance 2009. 2009, OECD Publishing OECD: Health at a Glance 2009. 2009, OECD Publishing
16.
go back to reference Municipal Health Services Act 1988-11-19 nr 66: Regulation of nursing homes and living facilities with continous care and tending; FOR 1988-11-14 nr 932. Municipal Health Services Act 1988-11-19 nr 66: Regulation of nursing homes and living facilities with continous care and tending; FOR 1988-11-14 nr 932.
17.
go back to reference Barker WH, Zimmer JG, Hall J, Ruff BC, Freundlich CBGME: Rates, Patterns, Causes and Costs of Hospitalization of Nursing Home Residents: A Population-Based Study. American Journal of Public Health. 1994, 84 (10): 5.CrossRef Barker WH, Zimmer JG, Hall J, Ruff BC, Freundlich CBGME: Rates, Patterns, Causes and Costs of Hospitalization of Nursing Home Residents: A Population-Based Study. American Journal of Public Health. 1994, 84 (10): 5.CrossRef
18.
go back to reference Rashidi F, Mowinckel P, Ranhoff AH: Severity of disease in patients admitted for acute care to a general hospital: Age and gender differences. Aging Clin Exp Res. 2009, 22 (4): 340-4.CrossRefPubMed Rashidi F, Mowinckel P, Ranhoff AH: Severity of disease in patients admitted for acute care to a general hospital: Age and gender differences. Aging Clin Exp Res. 2009, 22 (4): 340-4.CrossRefPubMed
19.
go back to reference Campbell SE, Seymour GD, Primrose WR: A systematic literature review of factors affecting outcome in older medical patients admitted to hospital. Age and Ageing. 2004, 33: 110-115. 10.1093/ageing/afh036.CrossRefPubMed Campbell SE, Seymour GD, Primrose WR: A systematic literature review of factors affecting outcome in older medical patients admitted to hospital. Age and Ageing. 2004, 33: 110-115. 10.1093/ageing/afh036.CrossRefPubMed
20.
go back to reference Konetzka RT, Spector W, Limcangco MR: Reducing Hospitalizations From Long-Term Care Settings. Medical Care Research and Review. 2008, 65 (1): 40-66.CrossRefPubMed Konetzka RT, Spector W, Limcangco MR: Reducing Hospitalizations From Long-Term Care Settings. Medical Care Research and Review. 2008, 65 (1): 40-66.CrossRefPubMed
21.
go back to reference Loeb M, Carusone SC, Goeree R, Walter SD, Brazil K, Krueger P, Simor A, Moss L, Marrie T: Effect of a Clinical Pathway to Reduce Hospitalizations in Nursing Home Residents With Pneumonia. JAMA: The Journal of the American Medical Association. 2006, 295 (21): 2503-2510. 10.1001/jama.295.21.2503.CrossRefPubMed Loeb M, Carusone SC, Goeree R, Walter SD, Brazil K, Krueger P, Simor A, Moss L, Marrie T: Effect of a Clinical Pathway to Reduce Hospitalizations in Nursing Home Residents With Pneumonia. JAMA: The Journal of the American Medical Association. 2006, 295 (21): 2503-2510. 10.1001/jama.295.21.2503.CrossRefPubMed
22.
go back to reference Intrator O, Zinn J, Mor V: Nursing Home Characteristics and Potentially Preventable Hospitalizations of Long-Stay Residents. Journal of the American Geriatrics Society. 2004, 52: 1730-1736. 10.1111/j.1532-5415.2004.52469.x.CrossRefPubMed Intrator O, Zinn J, Mor V: Nursing Home Characteristics and Potentially Preventable Hospitalizations of Long-Stay Residents. Journal of the American Geriatrics Society. 2004, 52: 1730-1736. 10.1111/j.1532-5415.2004.52469.x.CrossRefPubMed
23.
go back to reference Carter M: ED visits by older adults for ambulatory care-sensitive and supply sensitive conditions. Am J Emerg Med. 2006, 24: 428-434. 10.1016/j.ajem.2005.12.012.CrossRefPubMed Carter M: ED visits by older adults for ambulatory care-sensitive and supply sensitive conditions. Am J Emerg Med. 2006, 24: 428-434. 10.1016/j.ajem.2005.12.012.CrossRefPubMed
24.
go back to reference Walker JD, Teare GF, Hogan DB, Lewis S, Maxwell CJ: Identifying Potentially Avoidable Hospital Admissions From Canadian Long-Term Care Facilities. Medical Care. 2009, 47 (2): 5.CrossRef Walker JD, Teare GF, Hogan DB, Lewis S, Maxwell CJ: Identifying Potentially Avoidable Hospital Admissions From Canadian Long-Term Care Facilities. Medical Care. 2009, 47 (2): 5.CrossRef
Metadata
Title
Acute hospital admissions among nursing home residents: a population-based observational study
Authors
Birgitte Graverholt
Trond Riise
Gro Jamtvedt
Anette H Ranhoff
Kjell Krüger
Monica W Nortvedt
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2011
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-11-126

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