Emergency hospital admissions from care-homes: Who, why and what happens? A cross-sectional study

Quinn, T. (2011) Emergency hospital admissions from care-homes: Who, why and what happens? A cross-sectional study. Gerontology, 57(2), pp. 115-120. (doi: 10.1159/000314962)

Abstract

Background: An increasing number of adults are resident in care-homes. Poor prognosis is often assumed; however, outcomes in this group are not well described. We hypothesised that the clinical characteristics of emergency admissions from care-homes are no different from those of age-matched, community-dwelling elders. Objectives: To determine the clinical characteristics of unscheduled hospital admissions from care-homes in terms of severity of illness, admission diagnosis and outcome. To put these data into context, we compare them with data from age-matched, non-care-home resident, emergency admissions. Methods: The definition of care-home was a residential facility providing full-time care. We prospectively studied consecutive, unscheduled hospital admissions from care-homes to all receiving wards (medical, surgical and orthopaedic) in a central, urban, teaching hospital. Controls matched by age ( 1 year), gender, ward and admission date were independently collated. Basic descriptive statistics were employed for the analysis of clinical and demographic variables. Data were non-parametric and comparative analyses were based on chi(2) or Mann-Whitney tests as appropriate. Results: Over a 3-month period, there were 114 care-home admissions representing 80 patients (82 medical ward, 17 orthopaedic and 15 surgical). Demographics, co-morbidities and medication number were equivalent for cases and controls, as was the severity of the presenting illness (Modified Early Warning System scoring, serum albumin and C-reactive protein). Presenting diagnoses were heterogeneous with the majority of care-home admissions being secondary to sepsis (24; 29%) and falls (16; 19%). Care-home admissions and controls had similar inpatient mortality (14 vs. 15%; p = 0.84) and duration of stay (5 vs. 5 days; p = 0.73). There were a greater number of readmissions of patients from care-homes compared to the controls (26 vs. 3%; p < 0.0001). Conclusion: Care-home residents admitted for unscheduled hospital care have similar outcomes to age-matched, community dwelling admissions; however, their risk of readmission is substantially higher.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Quinn, Professor Terry
• Authors: Quinn, T.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Gerontology
• ISSN: 0304-324X