Social and Regional Factors Predict the Likelihood of Admission to a Nursing Home After Acute Hospital Stay in Elderly People with Chronic Health Conditions: A Multilevel Analysis Using Routinely Collected Hospital and Census Data in Switzerland.

2021 ◽  
Author(s):  
Nicole Bachmann ◽  
Andrea Zumbrunn ◽  
Lucy Bayer-Oglesby
Keyword(s):  
Health Care ◽  
Nursing Home ◽  
Hospital Discharge ◽  
Census Data ◽  
Acute Hospital ◽  
Living Alone ◽  
Nursing Home Admission ◽  
Chronic Health ◽  
Regional Factors ◽  
The Impact

Abstract Background: If hospitalisation becomes inevitable in the course of a chronic disease, discharge from acute hospital care in elderly individuals is often associated with temporary or persistent frailty, functional limitations and the need for help with daily activities. Thus, acute hospitalisation represents a particularly vulnerable phase of transient dependency on social support and health care. This study examines how social and regional inequality affect the decision for an institutionalisation after acute hospital discharge in Switzerland. Methods: The current analysis uses routinely collected inpatient data from all Swiss acute hospitals that was linked on the individual level with Swiss census data. The study sample included N=60,209 patients 75 years old and older living still at a private home and being hospitalised due to a chronic health condition in N=199 hospitals between 2010 and 2016. Random intercept multilevel logistic regression was used to assess the impact of social and regional factors on the odds of a nursing home admission after hospital discharge. Results: Results show that 7.8% of all patients were admitted directly to a nursing home after hospital discharge. We found significant effects of education level, insurance class, living alone and language regions on the odds of nursing home admission in a model adjusted for age, gender, nationality, health status, year of hospitalisation and hospital-level variance. The language regions moderated the effect of education and insurance class but not of living alone.Conclusion: Acute hospital discharge in elderly is a critical moment of transient dependency. Social and health care should work closely and coordinated together for a well-supported hospital discharge to avoid unnecessary institutionalisations of socially disadvantaged patients.

scholarly journals Predictors of Nursing Home Admission in the Older Population in Belgium

2022 ◽  
Author(s):  
Finaba Berete ◽  
Stefaan Demarest ◽  
Rana Charafeddine ◽  
Karin Ridder ◽  
Johan Vanoverloop ◽  
...  
Keyword(s):  
Health Care ◽  
Nursing Home ◽  
Home Care ◽  
Home Care Services ◽  
Subjective Health ◽  
Living Alone ◽  
Nursing Home Admission ◽  
Care Providers ◽  
Care Services

Abstract BackgroundThis study examines the risk factors associated with nursing home admission (NHA) in Belgium to contribute to a better planning of the future demand for nursing home (NH) services and health care resources.MethodsIndividual level linkage of the 2013 Belgian health interview survey data and health insurance data (2012 to 2018) was done. Only non-institutionalized participants, aged ≥65 years at the time of the survey were included in this study (n=1930). Participants were followed until NHA, death or end of study period, i.e., December 31, 2018. The risk of NHA was calculated using a competing risk analysis.ResultsOver the follow-up period (median 5.29 years), 226 individuals were admitted to a NH and 268 died without admission to a NH. The overall cumulative risk of NHA was 1.4%, 5.7% and 13.1% at, respectively 1 year, 3 years and the end of follow-up. After multivariable adjustment, higher age, low educational attainment, belonging to low income household, living alone, use of home care services and a number of need factor (e.g., history of falls, suffering from urinary incontinence, depression or Alzheimer disease, etc.) were significantly associated with a higher risk of NHA, while female, individuals with multimorbidity and increased contacts with health care providers were significantly associated with a decreased risk of NHA. Subjective health and limitations are both significant determinants of NHA, but subjective health is an effect modifier on the effect of limitations and vice versa.ConclusionsOur findings pinpoint important predictors of NHA in older adults, and offer possibilities of prevention to avoid or delay NHA for this population. The strong impact of need factors on the risk of NHA may indicate equitable access to NHA (i.e., those in need for support have access to NH). Practical implications include prevention of falls and appropriate and timely management of physical chronic conditions and neurodegenerative disorders. Focus should also be on people living alone to provide the appropriate social support and/or home care services. Further investigation of predictors of NHA should include contextual factors such as the availability of nursing-home beds, hospital beds, physicians and waiting lists for NHA.

scholarly journals The impact of attending day care designed for home-dwelling people with dementia on nursing home admission: a 24-month controlled study

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Anne Marie Mork Rokstad ◽  
Knut Engedal ◽  
Øyvind Kirkevold ◽  
Jūratė Šaltytė Benth ◽  
Geir Selbæk
Keyword(s):  
Nursing Home ◽  
Day Care ◽  
Nursing Home Admission ◽  
Controlled Study ◽  
People With Dementia ◽  
The Impact

scholarly journals Use of medication among nursing home residents: a Danish drug utilisation study

2020 ◽  
Vol 49 (5) ◽  
pp. 814-820 ◽  
Author(s):  
Carina Lundby ◽  
John Jensen ◽  
Søren Post Larsen ◽  
Helene Hoffmann ◽  
Anton Pottegård ◽  
...  
Keyword(s):  
Nursing Home ◽  
Drug Use ◽  
Drug Utilisation ◽  
Census Data ◽  
Nursing Home Residents ◽  
Nursing Home Admission ◽  
Drug Classes ◽  
Prescription Drug Use ◽  
Antidementia Drugs ◽  
New Treatments

Abstract Background Data on drug utilisation patterns in nursing home populations is scarce. We aimed to describe drug use patterns in Danish nursing home residents. Methods We established a cohort of 5,179 individuals (63% women; median age of 84 years) admitted into 94 nursing homes across Denmark during 2015–2017. Data on prescription drug use and other census data were obtained from the nationwide Danish health registries. Results The total number of drug classes filled increased from a median of 6 drugs (interquartile range [IQR] 3–9) at 18–24 months before nursing home admission to a median of 8 drugs (IQR 6–11) just after admission, with the most common drug classes comprising paracetamol (61%), platelet inhibitors (41%), proton pump inhibitors (34%), statins (33%) and potassium supplements (31%). The incidence rate of new drug treatments increased from 21 new treatments/100 residents/month at 12–24 months before admission to a peak of 71 new treatments/100 residents/month in the month prior to admission, while it levelled off to about 34 new treatments/100 residents/month after 6–9 months. The drug classes primarily responsible for this peak were laxatives, antibiotics and analgesics. The largest absolute increases were seen for laxatives (53%), paracetamol (43%) and antidepressants (36%), all showing a marked increase up to and following admission. A high proportion of residents remained on therapy in the 3-year period following admission, with users of antidepressants and antidementia drugs being most persistent. Conclusion Nursing home admission is associated with an increase in use of both predominantly preventive and non-preventive drug classes.

Combating agism: an imperative for contemporary health care

2001 ◽  
Vol 11 (3) ◽  
pp. 285-294 ◽  
Author(s):  
Sian Wade
Keyword(s):  
Health Care ◽  
Nursing Home ◽  
Older People ◽  
Quality Care ◽  
Acute Hospital ◽  
Continuing Care ◽  
Age Group ◽  
Age Profile ◽  
The Uk ◽  
Contemporary Health Care

The proportion of older people in the UK is increasing in relation to the population as a whole. This trend is reflected in the age profile of patients in hospital and those requiring continuing care in the community – domicilary, residential and nursing home sector. The HAS Report identified that more than 40% of patients over 65 with disability will require admission to an acute hospital over a two-year period. Ensuring appropriate, equitable and quality care for this age group is therefore a priority.

scholarly journals Understanding the Impact of Urinary Incontinence in Persons with Dementia: Development of an Interdisciplinary Service Model

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Patrick Juliebø-Jones ◽  
Elizabeth Coulthard ◽  
Elizabeth Mallam ◽  
Hilary Archer ◽  
Marcus J. Drake
Keyword(s):  
Nursing Home ◽  
Community Service ◽  
Urinary Symptoms ◽  
Nursing Home Admission ◽  
Average Score ◽  
Service Model ◽  
Validated Questionnaires ◽  
Care Partners ◽  
The Impact

Introduction. Prevalence of urinary symptoms such as incontinence (UI) in patients with dementia is estimated to exceed 50%. The resultant psychological and socio-economic burden can be substantial. Our aim was to develop a dedicated urology service within a cognitive impairment clinic in order to treat and better understand the bothersome urinary symptoms suffered by persons with dementia. Methods. Patients attending this clinic were invited to be assessed and interviewed by urologist, together with their family and/or carer. In addition, formal history, examination and relevant investigations, themes of importance such as quality of life, and select question items were drawn from validated questionnaires. Multidisciplinary team (MDT) meeting was carried out on the same day. Outcomes of the first 75 patients with UI and dementia have been reported. Results. Average age was 70 years (range 58–98). Majority of persons had a diagnosis of Alzheimer’s disease (n = 43, 57%). Average score for how much urine leakage interferes with everyday life was 7.7/10 (range 2–10). 58.7% (n = 44) revealed some degree of sleep disturbance due to UI. 83% (n = 62) stated daily activities were limited due to UI. Two-thirds of persons with dementia (n = 50) stated their bladder problem makes them feel anxious. 88% (n = 67) felt the topic was socially embarrassing. All carers stated that the person’s continence issues affect the care they provide. Less than one-third of carers (30.7%, n = 23) were aware of or had been in contact with any bladder and bowel community service. More than half of the carers (n = 46, 65%) were concerned incontinence may be a principal reason for future nursing home admission. Conclusion. UI can be distressing for persons with dementia. Care partners were concerned about loss of independence and early nursing home admission. Awareness of bladder and bowel services should be increased.

Tailored mental health care after nursing home admission: improving transfers of people with dementia with behavioral problems. An explorative study

2015 ◽  
Vol 19 (10) ◽  
pp. 902-911 ◽  
Author(s):  
L.D. Van Mierlo ◽  
A. Bootsma-Van der Wiel ◽  
F.J.M. Meiland ◽  
H.P.J. Van Hout ◽  
M.L. Stek ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Nursing Home ◽  
Mental Health Care ◽  
Behavioral Problems ◽  
Nursing Home Admission ◽  
Explorative Study ◽  
People With Dementia
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