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Unplanned nursing home admission among discharged polymedicated older inpatients: a single-centre, registry-based study in Switzerland
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Advisor(s)
Abstract(s)
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 antiParkinson’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
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Citation
Pereira, F., Verloo, H., von Gunten, A., Del Río Carral, M., Meyer-Massetti, C., Martins, M.M., Wernli, B. (2022). Unplanned nursing home admission among discharged polymedicated older inpatients: a single-centre, registry-based study in Switzerland. BMJ Open, 12(3), p. e057444
Publisher
BMJ Open Editorial