Predictors of Avoidable Hospitalizations Among Assisted Living Residents

Becker, Mary; Boaz, Timothy L.; Andel, Ross; DeMuth, Anne

doi:10.1016/j.jamda.2011.02.001

Cited by 36 publications

(34 citation statements)

References 29 publications

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“…Twenty-nine articles met the inclusion criteria [3,4,8-10,15,18-41]. Two articles reporting on the same study were considered as one source [21,38].…”

Section: Resultsmentioning

confidence: 99%

“…Most studies (n = 25) considered the general population of LTC residents; four studies focused on specific groups: residents with long-term neurological conditions [32], residents with advanced cognitive impairment [37], and residents at the end-of-life [31,39]. Mean age of the study samples ranged from 81 [31,41] to 86 years [37], and the proportion of women varied from 62% [15] to 80% [23]. …”

Section: Resultsmentioning

confidence: 99%

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Assessment tools for determining appropriateness of admission to acute care of persons transferred from long-term care facilities: a systematic review

et al. 2014

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BackgroundResidents of long-term care facilities have a high risk of acute care admission. Estimates of the frequency of inappropriate transfers vary substantially throughout the studies and various assessment tools have been used. The purpose of this study is to systematically review and describe the internationally existing assessment tools used for determining appropriateness of hospital admissions among long-term care residents.MethodSystematic review of the literature of two databases (PubMed and CINAHL®). The search covered seven languages and the period between January 2000 and December 2012. All quantitative studies were included if any assessment tool for appropriateness of hospital and/or emergency department admission of long-term care residents was used. Two pairs of independent researchers extracted the data.ResultsTwenty-nine articles were included, covering study periods between 1991 and 2009. The proportion of admissions considered as inappropriate ranged from 2% to 77%. Throughout the studies, 16 different assessment tools were used; all were based on expert opinion to some extent; six also took into account published literature or interpretation of patient data. Variation between tools depended on the concepts studied, format and application, and aspects evaluated. Overall, the assessment tools covered six aspects: specific medical diagnoses (assessed by n = 8 tools), acuteness/severity of symptoms (n = 7), residents’ characteristics prior to admission (n = 6), residents’ or families’ wishes (n = 3), existence of a care plan (n = 1), and availability or requirement of resources (n = 10). Most tools judged appropriateness based on one fulfilled item; five tools judged appropriateness based on a balance of aspects. Five tools covered only one of these aspects and only six considered four or more aspects. Little information was available on the psychometric properties of the tools.ConclusionsMost assessment tools are not comprehensive and do not take into account residents’ individual aspects, such as characteristics of residents prior to admission and wishes of residents or families. The generalizability of the existing tools is unknown. Further research is needed to develop a tool that is evidence-based, comprehensive and generalizable to different regions or countries in order to assess the appropriateness of hospital admissions among long-term care residents.

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“…Twenty-nine articles met the inclusion criteria [3,4,8-10,15,18-41]. Two articles reporting on the same study were considered as one source [21,38].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Assessment tools for determining appropriateness of admission to acute care of persons transferred from long-term care facilities: a systematic review

et al. 2014

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“…Many of the resident and facility level factors predictive of hospitalization parallel those reported for nursing homes 29e36,71 suggesting similar opportunities for targeting and/or developing interventions to reduce potentially inappropriate care transitions. 18,19,39,72,73 Although we believe that a proportion of the hospital admissions for DAL residents with dementia are potentially preventable, it is important to note that not all of these hospitalizations are inappropriate. As noted for the nursing home sector, 29 further research in AL 39,74 is required to better define strategies to prevent potentially inappropriate hospitalizations among this vulnerable population.…”

Section: Discussionmentioning

confidence: 98%

Elevated Hospitalization Risk of Assisted Living Residents With Dementia in Alberta, Canada

Maxwell

Amuah

Hogan

et al. 2015

Journal of the American Medical Directors Association

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“…Quantitative studies have focused on factors related to the hospital setting 10e12 as well as on risk factors related to measurable patient characteristics and health outcomes to reduce avoidable hospitalization and rehospitalization. 1,13,14 It has been shown that the risk for hospitalization among home health care patients increases with decreased functional ability, 14 lacking informal care, and incidence of chronic conditions as congestive heart failures (CHF), respiratory problems, wound problems and diabetes. 14,15 However, reasons for seeking hospital care seem to be more complex than can be captured by quantitative data.…”

Section: Introductionmentioning

confidence: 99%

In Hospital We Trust: Experiences of older peoples' decision to seek hospital care

et al. 2015

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Predictors of Avoidable Hospitalizations Among Assisted Living Residents

Cited by 36 publications

References 29 publications

Assessment tools for determining appropriateness of admission to acute care of persons transferred from long-term care facilities: a systematic review

Assessment tools for determining appropriateness of admission to acute care of persons transferred from long-term care facilities: a systematic review

Elevated Hospitalization Risk of Assisted Living Residents With Dementia in Alberta, Canada

In Hospital We Trust: Experiences of older peoples' decision to seek hospital care

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