Comparison of Hospitalization Between Nursing Home and Community Residents

Abstract

The authors prospectively identified 96 consecutive nursing home residents (NHR) admitted to the medical wards of their affiliated hospitals to determine the outcome of hospitalization for these patients in comparison with 88 admissions in a similarly aged community residents (CR) population. Nursing home and community resident groups were similar in age, sex, marital status, and distribution among the four study hospitals. Dementia was a more common preexisting diagnosis in NHR than in CR. Reasons for admission differed between the two groups. Although NHR experienced a longer hospitalization than CR, frequency and duration of intensive care unit admissions were similar. Fatal outcome occurred more commonly in NHR compared with CR (27 v 11%, P less than .001). Predictors of mortality were examined. Nursing home residents also experienced a higher mortality than CR within the six months after hospitalization (35 v 20%, P less than .005).

Reducing the Hospitalization of Nursing Home Residents

“…Iatrogenic complications of hospitalization, such as adverse drug reactions 3 and the development of pressure sores, 5 were avoided —although some may have occurred in the NH. The overall mortality (29%) was higher than reported in some previous studies, 6, 7 but similar to that in others 1, 5, 8 …”

“…The prominent role of infections in causing acute illness among NH residents has been highlighted by a number of studies 5–8 . Other studies have indicated that infection control policies in NHs are often poorly developed 10–11 .…”

Impact of the Type and Severity of Dementia on Hospitalization and Survival of the Elderly

“…Very few descriptions of the hospitalizations of nursing home residents have been reported [34], and different types of dementia with varying degrees of severity have not been compared before. In previous studies that did not distinguish between AD and VaD, the presence of an impaired cognitive status was found to be a significant predictor of hospitalization and of emergency room use [35,36]. In contrast, more recent studies have described a different scenario.…”

Precipitants of Emergency Room Visits and Acute Hospitalization in Short‐Stay Medicare Nursing Home Residents

“…Various resident, NH, physician‐practice, and illness characteristics may affect the decision to move a resident from NH to hospital. Until recently, studies of transfer from NH to hospital have been limited because they examined only residents who arrived at the hospital, 6,7 focused on a single NH or limited geographic area, 8–10 or did not examine the acute event that precipitated hospitalization 5,11,12 . Nevertheless, several domains worth examining have emerged from previous work.…”