Preventable hospitalization among nursing home residents: varying views between medical directors and directors of nursing regarding determinants.
OBJECTIVE
To compare the perception of the determinants of preventable hospitalization among nursing home residents by surveying medical directors (MDs) and directors of nursing (DONs).


METHODS
A survey (N = 52) was completed in January 2008. Data included resource availability, determinants of hospitalization, and nursing home practice. Multivariate linear regression examined the associations between potential determinants and preventable hospitalization.


RESULTS
Four significant determinants perceived by MDs to influence preventable hospitalization: MD/nurse practitioner (NP) access by pager, family preferences, access to medical history and lab/ electrocardiograph (EKG) reports, and physicians better paid to manage acutely ill residents (R(2) = .58). None of these factors were echoed by DONs (R(2) = .15). Whereas DONs perceived stat lab results on weekends were associated with increased hospitalization (p = .03), MDs did not (p = .28).


CONCLUSIONS
Our analysis showed that communication and consensus are important factors in the hospital transfer decision and that the discord in perceptions among MDs and DONs may complicate interventions to reduce preventable hospitalization.
Department of Health Policy, State University of New York at Albany, School of Public Health, One University Place, Room 171, Rensselaer, NY 12144, USA. yyoung@albany.edu
Yuchi
Y
Young
Sumant
S
Inamdar
Nancy R
NR
Barhydt
Anna D
AD
Colello
Edward L
EL
Hannan
D000704:Analysis of Variance; D019538:Health Care Surveys; D006760:Hospitalization; D006801:Humans; D007326:Institutionalization; D016014:Linear Models; D015999:Multivariate Analysis; D009518:New York; D009718:Nurse Administrators; D009735:Nursing Homes; D010359:Patient Readmission; D008486:Physician Executives; D018570:Risk Assessment / Q000379:methods; D013223:Statistics as Topic