Trend study on the association between hospital admissions and the health of Dutch older adults (1995–2009)

Galenkamp, Henrike; Deeg, Dorly J. H.; Jongh, Renate T. de; Kardaun, J. W. P. F.; Huisman, Martijn

doi:10.1136/bmjopen-2016-011967

Cited by 10 publications

(16 citation statements)

References 62 publications

(63 reference statements)

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“…To our knowledge, this is the first study to show a significant decrease in hospitalization risk through an ED‐based geriatric assessment and care transitions program . Many people seen in the ED setting appropriately require inpatient admission, and older adults have higher rates of admission than the general population, but retrospective review of existing hospitalization data indicates that many of these admissions may be avoidable . Hospitalization of older adults has significant risks of iatrogenic complications, including potentially inappropriate medication prescribing .…”

Section: Discussionmentioning

confidence: 89%

Geriatric Emergency Department Innovations: Transitional Care Nurses and Hospital Use

Hwang

Dresden

Rosenberg

et al. 2018

J American Geriatrics Society

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INTERVENTION:The intervention was first TCN contact. Controls never saw a TCN during the study period. MEASUREMENTS: We examined sociodemographic and clinical characteristics associated with TCN use and outcomes. The primary outcome was inpatient admission during the index ED visit (admission on Day 0). Secondary outcomes included cumulative 30-day admission (any admission on Days 0-30) and 72-hour ED revisits. RESULTS: A TCN saw 5,930 (10%) individuals, 42% of whom were admitted. After accounting for observed selection bias using entropy balance, results showed that when compared to controls, TCN contact was associated with lower risk of admission (site 1: À9.9% risk of inpatient admission, 95% confidence interval (CI) = À12.3% to À7.5%; site 2: À16.5%, 95% CI = À18.7% to À14.2%; site 3: À4.7%, 95% CI = À7.5% to À2.0%). Participants with TCN contact had greater risk of a 72-hour ED revisit at two sites (site 1: 1.5%, 95% CI = 0.7-2.3%; site 2: 1.4%, 95% CI = 0.7-2.1%). Risk of any admission within 30 days of the index ED visit also remained lower for TCN patients at both these sites (site 1: À7.8%, 95% CI = À10.3% to À5.3%; site 2: À13.8%, 95% CI = À16.1% to À11.6%). CONCLUSION: Targeted evaluation by geriatric ED transitions of care staff may be an effective delivery innovation to reduce risk of inpatient admission. J Am Geriatr Soc 2018.

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Section: Discussionmentioning

confidence: 89%

Geriatric Emergency Department Innovations: Transitional Care Nurses and Hospital Use

Hwang

Dresden

Rosenberg

et al. 2018

J American Geriatrics Society

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“…Lau et al (2007) [19] proposed a model for health-related safety that extends beyond the traditional definition of patient safety and incorporates this wider range of risk factors. Studies have shown, for example, that older people with functional limitations, cognitive problems or low psychosocial resources are at increased risk of unwanted outcomes such as avoidable hospital admissions [20][21][22]. Therefore, it is important to focus efforts on the mitigation of such risks and the prevention of problems.…”

Section: Research and Theorymentioning

confidence: 99%

Supporting Older People to Live Safely at Home – Findings from Thirteen Case Studies on Integrated Care Across Europe

et al. 2020

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Introduction: While many different factors can undermine older people's ability to live safely at home, safety as an explicit aspect of integrated care for older people living at home is an underexplored topic in research. In the context of a European project on integrated care, this study aims to improve our understanding of how safety is addressed in integrated care practices across Europe. Methods: This multiple case study included thirteen integrated care sites from seven European countries. The Framework Method guided content analyses of the case study reports. Activities were clustered into activities aimed at identifying and managing risks, or activities addressing specific risks related to older people's functioning, behaviour, social environment, physical environment and health and social care receipt. Results: Case studies included a broad range of activities addressing older people's safety. Although care providers felt they sufficiently addressed safety issues, older people were often concerned and insecure about their safety. Attention to the practical and social aspects of safety was often insufficient. Conclusions and discussion: Integrated care services across Europe address older people's safety in many ways. Further integration of health and social care solutions is necessary to enhance older people's perceptions of safety.

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“…the number of chronic conditions and functional limitations, varies between countries and different age cohorts but the conclusion is that the most severe disabilities have decreased while mild disability has increased (Rechel et al 2013), as has the number of chronic conditions (Prince et al 2015). In the Netherlands, Galenkamp et al (2012Galenkamp et al ( , 2016 had similar findings. The number of chronic conditions and mild disabilities had increased, results supported later by Alders, Comijs and Deeg (2016), and the increase was stronger among the older old (aged 75-85) than among the younger old (aged 60-74) (Galenkamp et al 2012).…”

Section: Individual Determinants Of Care Usementioning

confidence: 98%

Trends in the use of care among people aged 65–85 with cognitive impairment in the Netherlands

et al. 2018

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Observation of long-term trends within countries is needed to increase insight into how policy initiatives are reflected in the use of care over time in addition to individual determinants of care use. In the past decades, Dutch care policies have favoured homecare and reduced the availability of institutional care which extended the care responsibilities of formal and informal care-givers at home. This study investigates the changes in the use of informal and formal homecare, community services and residential care among cognitively impaired older adults over time in the Netherlands. In addition, of special interest here are the associations of the presence of a spouse, other family members or social network with care use, and the interdependency between the use of different types of care. The study employs the Longitudinal Aging Study Amsterdam (LASA) covering the years 1992-2012, analysed with generalised estimating equations. The data consisted of 1,022 observations gathered from 813 respondents aged 65-85. The respondents were cognitively impaired according to the age-and education-standardised Mini-Mental State Examination score. The analyses took into account several individual determinants of care use. The use of informal care and residential care decreased while the use of formal homecare and community services remained the same. Simultaneously, the proportion of those who did not use the studied care types increased. The contribution of partners in informal care decreased. Informal care and formal homecare use increasingly became complementary services. The findings suggest that the decreases in informal care and residential care have not been replaced by other types of care, as reflected in the increased number of persons receiving no care. Care policies should not rely excessively on the availability of informal help and should guarantee adequate formal help, especially for those in high need.

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Trend study on the association between hospital admissions and the health of Dutch older adults (1995–2009)

Cited by 10 publications

References 62 publications

Geriatric Emergency Department Innovations: Transitional Care Nurses and Hospital Use

Geriatric Emergency Department Innovations: Transitional Care Nurses and Hospital Use

Supporting Older People to Live Safely at Home – Findings from Thirteen Case Studies on Integrated Care Across Europe

Trends in the use of care among people aged 65–85 with cognitive impairment in the Netherlands

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