Potentially avoidable hospitalizations for older patients transferred from long-term care hospitals: a nationwide cross-sectional analysis of potential healthcare consequences

被引:0
作者
Seonji Kim
Sung-keun Ko
Tae Young Lee
Jin-Hee Lee
机构
[1] Yonsei University College of Medicine,Department of Biomedical Systems Informatics
[2] National Emergency Medical Center,undefined
[3] National Medical Center,undefined
来源
Internal and Emergency Medicine | 2023年 / 18卷
关键词
Older patients; Emergency departments; Long-term care hospital; Ambulatory care sensitive conditions; Overcrowding;
D O I
暂无
中图分类号
学科分类号
摘要
Multiple chronic disorders and disabilities among older patients in long term care hospitals (LTCH) tends to increase the healthcare burden by causing overcrowding, particularly in emergency departments. Therefore, access to timely and adequate healthcare for LTCH patients is an increasingly important issue, and potentially avoidable hospitalizations (PAHs) and hospitalizations during non-office hours can result as indicators of emergency department overcrowding. The study aimed to evaluate PAHs and hospitalizations during non-office hours in emergency departments for older patients transferred from LTCH compared to patients living at home. We performed a cross-sectional study using the National Emergency Department Information System database from January 2018 to December 2019, in South Korea, with older patients (≥ 65 years) who visited nationwide emergency departments. Adjusted odds ratio (aOR) and 95% confidence interval (CI) for indicators of overcrowding as PAHs and hospitalizations during non-office hours were calculated by logistic regression. Among the 2,177,663 older patients who visited the emergency departments, 98,434 patients were living in LTCH and 2,079,229 patients were living at home. The older patients living in LTCH was associated with PAHs (aOR: 1.90, 95% CI 1.87–1.94) and hospitalizations during non-office hours (aOR: 1.76, 95% CI 1.73–1.78). LTCH patients showed more hospital visits, extended stay in the emergency department, greater prevalence of chronic diseases, greater rates of transfer as well as higher admission rates and mortality as compared to the patients living at home. The LTCH older patients were associated with the indicators of emergency department overcrowding, which impacts health care quality in hospitals. Introduction of policy and training programs for LTCH staff are recommended to manage vulnerable groups in advance.
引用
收藏
页码:169 / 176
页数:7
相关论文
共 41 条
  • [1] Atella V(2019)Trends in age-related disease burden and healthcare utilization Aging Cell 18 e12861-766
  • [2] Salini S(2022)Frailty network in an acute care setting: the new perspective for frail older people Diagnostics 12 1228-374
  • [3] Dwyer R(2014)A systematic review of outcomes following emergency transfer to hospital for residents of aged care facilities Age Ageing 43 759-635
  • [4] Godden S(2001)The use of acute hospital services by elderly residents of nursing and residential care homes Health Soc Care Community 9 367-8
  • [5] Pollock AM(2010)Potentially avoidable hospitalizations of nursing home residents: frequency causes, and costs: [See editorial comments by Drs. Jean F. Wyman and William R. Hazzard, pp 760-761] J Am Geriatr Soc 58 627-8
  • [6] Ouslander JG(2014)Assessment tools for determining appropriateness of admission to acute care of persons transferred from long-term care facilities: a systematic review BMC Geriatr 14 1-318
  • [7] Renom-Guiteras A(2011)Acute hospital admissions among nursing home residents: a population-based observational study BMC Health Serv Res 11 1-1761
  • [8] Graverholt B(2009)Use of emergency departments by older people from residential care: a population based study Age Ageing 38 314-50
  • [9] Ingarfield SL(2007)The costs and potential savings associated with nursing home hospitalizations Health Aff 26 1753-495
  • [10] Grabowski DC(2004)Estimating the degree of emergency department overcrowding in academic medical centers : results of the national ED overcrowding study (NEDOCS) Acad Emerg Med 11 38-9