Inma Sánchez-Pérez1, Nuri Comes Garcia2, Lola Romero Piniella3, Gemma Prats Martos4, Gemma Arnau Bataller5, Jordi Coderch6. 1. Grup de Recerca en Serveis Sanitaris i Resultats en Salut (GRESSIRES), Serveis de Salut Integrats Baix Empordà (SSIBE), Palamós (Girona), España. Electronic address: isanchezp@ssibe.cat. 2. Centro Sociosanitario Palamós Gent Gran, Serveis de Salut Integrats Baix Empordà (SSIBE), Palamós (Girona), España. 3. Residencia Asistida y Centro de Día Sant Feliu de Guíxols Gent Gran, Fundació Guíxols Surís, Sant Feliu de Guíxols (Girona), España. 4. Residencia Asistida y Centro de Día Palafrugell Gent Gran, Fundació Palafrugell Gent Gran, Palafrugell (Girona), España. 5. Servicio de Urgencias, Hospital de Palamós, Serveis de Salut Integrats Baix Empordà (SSIBE), Palamós (Girona), España. 6. Grup de Recerca en Serveis Sanitaris i Resultats en Salut (GRESSIRES), Serveis de Salut Integrats Baix Empordà (SSIBE), Palamós (Girona), España.
Abstract
OBJECTIVE: Hospital emergencies (HE) arising from nursing homes (NH) are on the rise. We analyse the evolution, characteristics and appropriateness of HE of NH residents in a region, as well as resulting hospital admissions. METHOD: Retrospective descriptive study between 2010 and 2013 of institutionalised residents of 11 NH located in Baix Empordà (704 beds) and Palamós Hospital. VARIABLES: Gender, age, morbidity and relative weight according to clinical risk groups (CRG), NH, length of stay, diagnosis of the emergency, appropriateness of HE according to Bermejo's criteria and the HE appropriateness protocol (HEAP), and appropriateness of hospitalisations according to the Appropriateness Evaluation Protocol (AEP). Sample to evaluate appropriateness: 159 HE and 91 hospitalisations. STATISTICAL ANALYSIS: frequency, mean, standard deviation, percentiles, Fisher's exact test and ANOVA, with a confidence interval of 95% and using IBM SPSS Statistics 23. RESULTS: 1,474 people were enrolled, of which 73% were women. Group ≥85 years increased to 60.3% and the mean weight of morbidity was 3.2 to 4.0 (p <0.001). 1,805 HE were generated. The annual rate per 1,000 stays arising from NH increased from 1.64 to 2.05, of which 90.6% were appropriate according to Bermejo's criteria and 93.7% according to the HEAP. Of these, 502 involved hospitalisation. The annual rate per 10 emergencies fell from 2.96 to 2.64 and 98.9% were appropriate according to the AEP. CONCLUSIONS: Hospital emergencies and hospitalisations of NH residents are increasing and are appropriate. Increasing age and disease burden could explain this phenomenon. NH and hospitals should react appropriately, considering the specific needs of this population sector.
OBJECTIVE: Hospital emergencies (HE) arising from nursing homes (NH) are on the rise. We analyse the evolution, characteristics and appropriateness of HE of NH residents in a region, as well as resulting hospital admissions. METHOD: Retrospective descriptive study between 2010 and 2013 of institutionalised residents of 11 NH located in Baix Empordà (704 beds) and Palamós Hospital. VARIABLES: Gender, age, morbidity and relative weight according to clinical risk groups (CRG), NH, length of stay, diagnosis of the emergency, appropriateness of HE according to Bermejo's criteria and the HE appropriateness protocol (HEAP), and appropriateness of hospitalisations according to the Appropriateness Evaluation Protocol (AEP). Sample to evaluate appropriateness: 159 HE and 91 hospitalisations. STATISTICAL ANALYSIS: frequency, mean, standard deviation, percentiles, Fisher's exact test and ANOVA, with a confidence interval of 95% and using IBM SPSS Statistics 23. RESULTS: 1,474 people were enrolled, of which 73% were women. Group ≥85 years increased to 60.3% and the mean weight of morbidity was 3.2 to 4.0 (p <0.001). 1,805 HE were generated. The annual rate per 1,000 stays arising from NH increased from 1.64 to 2.05, of which 90.6% were appropriate according to Bermejo's criteria and 93.7% according to the HEAP. Of these, 502 involved hospitalisation. The annual rate per 10 emergencies fell from 2.96 to 2.64 and 98.9% were appropriate according to the AEP. CONCLUSIONS: Hospital emergencies and hospitalisations of NH residents are increasing and are appropriate. Increasing age and disease burden could explain this phenomenon. NH and hospitals should react appropriately, considering the specific needs of this population sector.
Authors: Emilio Mota-Romero; Beatriz Tallón-Martín; María P García-Ruiz; Daniel Puente-Fernandez; María P García-Caro; Rafael Montoya-Juarez Journal: Medicina (Kaunas) Date: 2021-01-14 Impact factor: 2.430