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Hospitalization of nursing home residents in an acute-care geriatric department: direct versus emergency room admission.
Isr Med Assoc J 2001; 3(10):734-8IM

Abstract

BACKGROUND

Transfer to an emergency room and hospitalization of nursing home residents is a growing problem that is poorly defined and reported.

OBJECTIVES

To assess the clinical effectiveness of a pilot project involving hospitalization of nursing home residents directly to an acute-care geriatric department.

METHODS

We retrospectively compared the hospitalization in an acute-care geriatric unit of 126 nursing home residents admitted directly to the unit and 80 residents admitted through the emergency room. The variables measured included length of stay, discharge disposition, mortality, cause of hospitalization, chronic medical condition, cognitive state, functional status at admission, and change of functional status during the hospital stay. Follow-up data were obtained from medical records during the 2 years study.

RESULTS

No significant differences between the groups were found for length of stay, mortality, discharge disposition and most characteristics of the hospital stay. The only significant difference was in patients' mean age, as emergency room patients were significantly older (86 vs. 82.9 years). The most common condition among nursing home patients admitted via the emergency room was febrile disease (36.9%), while functional decline was the most common in those coming directly from the nursing home (32.5%). The prevalence of functional dependence and dementia were similar in both groups. Functional status did not change throughout the hospital stay in most patients.

CONCLUSIONS

Treatment of selected nursing home residents admitted directly from the nursing home to an acute-care geriatric unit is feasible, medically effective, results in the safe discharge of almost all such patients and provides an alternative to transfer to an emergency room. This study suggests that quality gains and cost-effective measures may be achieved by such a project, although a randomized controlled trial is necessary to support this hypothesis.

Authors+Show Affiliations

Fliman Geriatric Hospital and Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. eaizen_il@yahoo.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11692547

Citation

Aizen, E, et al. "Hospitalization of Nursing Home Residents in an Acute-care Geriatric Department: Direct Versus Emergency Room Admission." The Israel Medical Association Journal : IMAJ, vol. 3, no. 10, 2001, pp. 734-8.
Aizen E, Swartzman R, Clarfield AM. Hospitalization of nursing home residents in an acute-care geriatric department: direct versus emergency room admission. Isr Med Assoc J. 2001;3(10):734-8.
Aizen, E., Swartzman, R., & Clarfield, A. M. (2001). Hospitalization of nursing home residents in an acute-care geriatric department: direct versus emergency room admission. The Israel Medical Association Journal : IMAJ, 3(10), pp. 734-8.
Aizen E, Swartzman R, Clarfield AM. Hospitalization of Nursing Home Residents in an Acute-care Geriatric Department: Direct Versus Emergency Room Admission. Isr Med Assoc J. 2001;3(10):734-8. PubMed PMID: 11692547.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hospitalization of nursing home residents in an acute-care geriatric department: direct versus emergency room admission. AU - Aizen,E, AU - Swartzman,R, AU - Clarfield,A M, PY - 2001/11/6/pubmed PY - 2002/1/5/medline PY - 2001/11/6/entrez SP - 734 EP - 8 JF - The Israel Medical Association journal : IMAJ JO - Isr. Med. Assoc. J. VL - 3 IS - 10 N2 - BACKGROUND: Transfer to an emergency room and hospitalization of nursing home residents is a growing problem that is poorly defined and reported. OBJECTIVES: To assess the clinical effectiveness of a pilot project involving hospitalization of nursing home residents directly to an acute-care geriatric department. METHODS: We retrospectively compared the hospitalization in an acute-care geriatric unit of 126 nursing home residents admitted directly to the unit and 80 residents admitted through the emergency room. The variables measured included length of stay, discharge disposition, mortality, cause of hospitalization, chronic medical condition, cognitive state, functional status at admission, and change of functional status during the hospital stay. Follow-up data were obtained from medical records during the 2 years study. RESULTS: No significant differences between the groups were found for length of stay, mortality, discharge disposition and most characteristics of the hospital stay. The only significant difference was in patients' mean age, as emergency room patients were significantly older (86 vs. 82.9 years). The most common condition among nursing home patients admitted via the emergency room was febrile disease (36.9%), while functional decline was the most common in those coming directly from the nursing home (32.5%). The prevalence of functional dependence and dementia were similar in both groups. Functional status did not change throughout the hospital stay in most patients. CONCLUSIONS: Treatment of selected nursing home residents admitted directly from the nursing home to an acute-care geriatric unit is feasible, medically effective, results in the safe discharge of almost all such patients and provides an alternative to transfer to an emergency room. This study suggests that quality gains and cost-effective measures may be achieved by such a project, although a randomized controlled trial is necessary to support this hypothesis. SN - 1565-1088 UR - https://www.unboundmedicine.com/medline/citation/11692547/Hospitalization_of_nursing_home_residents_in_an_acute_care_geriatric_department:_direct_versus_emergency_room_admission_ L2 - http://www.ima.org.il/IMAJ/ViewArticle.aspx?year=2001&month=10&page=734 DB - PRIME DP - Unbound Medicine ER -