Pereira, Filipa; Verloo, Henk; von Gunten, Armin; Del Río Carral, María; Meyer-Massetti, Carla; Martins, Maria Manuela; Wernli, Boris (2022). Unplanned nursing home admission among discharged polymedicated older inpatients: a single-centre, registry-based study in Switzerland. BMJ open, 12(3), e057444. BMJ Publishing Group 10.1136/bmjopen-2021-057444
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OBJECTIVE
To investigate patient characteristics and the available health and drug data associated with unplanned nursing home admission following an acute hospital admission or readmission.
DESIGN
A population-based hospital registry study.
SETTING
A public hospital in southern Switzerland (Valais Hospital).
PARTICIPANTS
We explored a population-based longitudinal dataset of 14 705 hospital admissions from 2015 to 2018.
OUTCOME MEASURES
Sociodemographic, health and drug data, and their interactions predicting the risk of unplanned nursing home admission.
RESULTS
The mean prevalence of unplanned nursing home admission after hospital discharge was 6.1% (n=903/N=14 705). Our predictive analysis revealed that the oldest adults (OR=1.07 for each additional year of age; 95% CI 1.05 to 1.08) presenting with impaired functional mobility (OR=3.22; 95% CI 2.67 to 3.87), dependency in the activities of daily living (OR=4.62; 95% CI 3.76 to 5.67), cognitive impairment (OR=3.75; 95% CI 3.06 to 4.59) and traumatic injuries (OR=1.58; 95% CI 1.25 to 2.01) had a higher probability of unplanned nursing home admission. The number of International Classification of Diseases, 10th version diagnoses had no significant impact on nursing home admissions, contrarily to the number of prescribed drugs (OR=1.17; 95% CI 1.15 to 1.19). Antiemetics/antinauseants (OR=2.53; 95% CI 1.21 to 5.30), digestives (OR=1.78; 95% CI 1.09 to 2.90), psycholeptics (OR=1.76; 95% CI 1.60 to 1.93), antiepileptics (OR=1.49; 95% CI 1.25 to 1.79) and anti-Parkinson's drugs (OR=1.40; 95% CI 1.12 to 1.75) were strongly linked to unplanned nursing home admission.
CONCLUSIONS
Numerous risk factors for unplanned nursing home admission were identified. To prevent the adverse health outcomes that precipitate acute hospitalisations and unplanned nursing home admissions, ambulatory care providers should consider these risk factors in their care planning for older adults before they reach a state requiring hospitalisation.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine 04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM) |
UniBE Contributor: |
Meyer-Massetti, Carla Verena |
Subjects: |
300 Social sciences, sociology & anthropology > 360 Social problems & social services 600 Technology > 610 Medicine & health |
ISSN: |
2044-6055 |
Publisher: |
BMJ Publishing Group |
Funders: |
[4] Swiss National Science Foundation |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
07 Mar 2022 09:09 |
Last Modified: |
05 Dec 2022 16:12 |
Publisher DOI: |
10.1136/bmjopen-2021-057444 |
PubMed ID: |
35246423 |
Uncontrolled Keywords: |
clinical pharmacology epidemiology geriatric medicine health informatics |
BORIS DOI: |
10.48350/166606 |
URI: |
https://boris.unibe.ch/id/eprint/166606 |
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