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Hospital Admissions from Nursing Homes: Rates and Reasons
| Content Provider | Open Access Library (OALib) |
|---|---|
| Author | Kjell Krüger Kristian Jansen Anders Grimsmo Geir Egil Eide Jonn Terje Geitung |
| Abstract | Hospital admissions from nursing homes have not previously been investigated in Norway. During 12 months all hospital admissions (acute and elective) from 32 nursing homes in Bergen were recorded via the Norwegian ambulance register. The principal diagnosis made during the stay, length of stay, and the ward were sourced from the hospital's data register and data were merged. Altogether 1,311 hospital admissions were recorded during the 12 months. Admissions from nursing homes made up 6.1% of the total number of admissions to medical wards, while for surgical wards they made up 3.8%. Infections, fractures, cardiovascular and gastri-related diagnoses represented the most frequent admission diagnoses. Infections accounted for 25.0% of admissions, including 51.0% pneumonias. Of all the admissions, fractures were the cause in 10.2%. Of all fractures, hip fractures represented 71.7. The admission rate increased as the proportion of short-term beds increased, and at nursing homes with short-term beds, admissions increased with increasing physician coverage. Potential reductions in hospitalizations for infections from nursing homes may play a role to reduce pressure on medical departments as may fracture prevention. Solely increasing physician coverage in nursing homes will probably not reduce the number of hospitalizations. 1. Background It is expected that nursing homes will play an important role in health care delivery in the years ahead. The population is growing older, and the patients admitted to hospitals are being discharged earlier. A Norwegian white paper states that reform is needed to the collaboration between primary care and hospitals [1]. The growth in costs and utilization of hospitals is not sustainable. Among several proposals, the white paper points to accomplishments involving early discharges from hospitals to nursing homes, which offer structured rehabilitation programmes. Evaluations have shown a reduction in mortality, readmission, and later need for home care for elderly patients [2]. Palliative units in nursing homes have also been a success [3]. On the other hand, little research has been done on admissions from nursing home to hospital. There are no studies in this field from Norway [4]. Internationally, a correlation has been found between the lack of documented decisions on the level of treatment and the increase in admission rate [5]. Clear documentation in logs and records concerning hospital admissions and heart-lung do-not-resuscitate decisions can prevent unnecessary admissions. Acknowledged routines currently in place to |
| ISSN | 20901429 |
| Journal | Nursing Research and Practice |
| DOI | 10.1155/2011/247623 |
| Publisher | Hindawi Publishing Corporation |
| Publisher Date | 2011-01-01 |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
| Subject | Nursing |
