Factors associated with potentially preventable hospitalization in nursing home residents in New York State: a survey of directors of nursing.
OBJECTIVE
To describe characteristics of New York State nursing homes and identify factors associated with potentially preventable hospitalization in nursing home residents.


METHODS
Cross-sectional survey.


METHODS
Randomly selected nursing homes in New York State.


METHODS
One hundred forty-seven directors of nursing (DONs).


METHODS
Data were collected using a Web-based survey completed in January 2008. Variables included specific aspects of facility environment, nurse and aide services, resource availability, perceived determinants of hospitalization, and nursing home practice. Stepwise multivariate linear regression examined the associations between perceived determinants and potentially preventable hospitalization.


RESULTS
Factors associated with potentially preventable hospitalization included presence of nursing staff trained to communicate effectively with physicians (P<.001); easy access to urgent laboratory results in less than 4 hours on weekends (P=.03); that physicians attempt to treat patients within the nursing home and admit to the hospital as a last resort (P<.001); higher reported proportion of residents enrolled in managed care plans for regular medical care (P=.04); higher perceived likelihood that illness will cause death (P=.03); perceived inadequate access by physicians to residents' and prior medical history, laboratory results, and electrocardiograms (ECGs) (P=.02), as reported by DONs.


CONCLUSIONS
Efficient and effective care depends on continuity of communication between nurses and physicians and adequate access to patients' medical history, laboratory results, and ECGs. The following operational strategies may help institutions reduce potentially preventable hospitalizations: ensure effective communication between nursing staff and physicians regarding patients' condition; provide physicians with easy access to stat laboratory results in less than 4 hours on weekends and adequate access to the patient's medical history, laboratory results, and ECGs; and motivate physicians to treat residents within the nursing home whenever possible.
Young
Yuchi
Y
Department of Health Policy, Management and Behavior, School of Public Health, State University of New York at Albany, Albany, New York 12144, USA. yyoung@albany.edu
Barhydt
Nancy R
NR
Broderick
Suzanne
S
Colello
Anna D
AD
Hannan
Edward L
EL
D022126:Access to Information; D000288:Administrative Personnel; D001291:Attitude of Health Personnel; D003142:Communication; D003430:Cross-Sectional Studies; D003625:Data Collection; D006760:Hospitalization; D006801:Humans; D009518:New York; D009726:Nurses; D009728:Nursing Assistants; D009735:Nursing Homes / Q000458:organization & administration*; D010360:Patient Transfer; D019555:Physician-Nurse Relations; D000078329:Workforce