Hospitalization of nursing home residents in an acute-care geriatric department: Direct versus emergency room admission

Efraim Aizen, Rachel Swartzman, A. Mark Clarfield

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

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 year 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 differences 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.

Original languageEnglish
Pages (from-to)734-738
Number of pages5
JournalIsrael Medical Association Journal
Volume3
Issue number10
StatePublished - 1 Dec 2001
Externally publishedYes

Keywords

  • Emergency room
  • Geriatric department
  • Hospitalization
  • Nursing home

ASJC Scopus subject areas

  • General Medicine

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