Factors associated with increased hospitalisation risk among nursing home residents in Sweden: a prospective study with a three‐year follow‐up

• DOI: 10.1111/opn.12107
• Publication Date: 2015-12-13T03:11:16Z
• Authors: Jenny Hallgren; Marie Ernsth Bravell; Sigvard Mölstad; Carl Johan Östgren; Patrik Midlöv; Anna K. Dahl Aslan
• Keywords: Male; hospitalization; nursing home residents; preventive care; prospective design; Comorbidity; Risk Assessment; 03 medical and health sciences; 0302 clinical medicine; Risk Factors; Humans; Gerontologi, medicinsk/hälsovetenskaplig inriktning; Gerontology, specialising in Medical and Health Sciences; Prospective Studies; Aged; Proportional Hazards Models; Aged, 80 and over; Sweden; 2. Zero hunger; Malnutrition; Nursing Homes; 3. Good health; Hospitalization; Cardiovascular Diseases; Polypharmacy; Accidental Falls; Female; Follow-Up Studies

BackgroundHospitalisation of nursing home residents might lead to deteriorating health.AimTo evaluate physical and psychological factors associated with hospitalisation risk among nursing home residents.DesignProspective study with three years of follow‐up.MethodsFour hundred and twenty‐nine Swedish nursing home residents, ages 65–101 years, from 11 nursing homes in three municipalities were followed during three years. The participants' physical and psychological status was assessed at baseline. A Cox proportional hazards model was used to evaluate factors associated with hospitalisation risk using STATA.ResultsOf the 429 participants, 196 (45.7%) were hospitalised at least once during the three‐year follow‐up period, and 109 (25.4%) during the first six months of the study. The most common causes of hospitalisation were cardiovascular diseases or complications due to falls. A Cox regression model showed that residents who have had previous falls (P < 0.001), are malnourished (P < 0.001), use a greater number of drugs (P < 0.001) and have more diseases (P < 0.001), are at an increased risk of hospitalisation.ConclusionNursing home residents are frequently hospitalised, often due to falls or cardiovascular diseases. Study results underscore the relationships between malnutrition, previous falls, greater numbers of drugs and diseases and higher risk of hospitalisation.Implications for practicePreventive interventions aimed at malnutrition and falls at the nursing home could potentially reduce the number of hospitalisations. With improved education and support to nurses concerning risk assessment at the nursing homes, it may be possible to reduce the numbers of avoidable hospitalisation among nursing home residents and in the long run improve quality of life and reduce suffering.