What Are the Main Reasons for Hospital Admissions in Nursing Home Patients

Content Provider	Semantic Scholar
Author	Warren, Connolly Tom, Benicio Sinead, Healy-Evans Mc, Carthy Christine Hina, Butt Tracey, Keating Dermot, Power Joseph, D.
Copyright Year	2018
Abstract	Nursing Home (NH) residents are frail, functionally dependent and have a high prevalence of dementia. NH residents who attended the Emergency Department present with advanced disease and are more likely to require admission compared to their community-dwelling counterparts. The aim of the study was to examine the reasons for admission of NH residents in a region with a NH outreach programme. The findings may help to develop alternative clinical pathways involving early community intervention which may help avert hospital admissions for this cohort. Methods: NH residents from Dublin North Central who required hospital admission over a 12-month period were identified using the hospital electronic patient record. The demographics, frequency of admission, discharge diagnosis, length of stay (LOS) and inpatient mortality were recorded. Results: Three hundred and fifty-six NH residents (140 men and 216 women) had 498 hospital admissions over a 12-month period. The common reasons for admission were infection (n = 197, 40%), falls and fractures (n = 96, 19%), cardiac causes (n = 42, 8%), gastrointestinal complaints (n = 37, 7%) and stroke or transient ischaemic attack (n = 26, 5%). The median LOS was 8 days and infection-related diagnoses accounted for one-third of the total bed-days and falls and fractures for another third of bed days. Forty-three (12.1%) NH residents died as inpatients and the median hospital LOS to death was 6 days (1-90). Discussion: Infection, in particular respiratory infection, and falls were the two most common reasons for hospitalisation in NH residents. A clear pathway including vaccination, management of infection in the NH and rapid access to a community hospital may reduce acute hospital attendance. In severely frail residents, a clear advanced health care directive and skilled educated nursing staff in the NH may allow terminally ill patients to die in their NH.
File Format	PDF HTM / HTML
DOI	10.23937/2469-5858/1510039
Volume Number	4
Alternate Webpage(s)	https://clinmedjournals.org/articles/jgmg/journal-of-geriatric-medicine-and-gerontology-jgmg-4-039.pdf
Alternate Webpage(s)	https://doi.org/10.23937/2469-5858%2F1510039
Language	English
Access Restriction	Open
Content Type	Text
Resource Type	Article