title: High mortality of older patients admitted to hospital from care homes and insight into potential interventions to reduce hospital admissions from care homes: the Norfolk experience.
abstract: There is a high mortality rate in patients admitted to hospitals acutely from care homes. In a retrospective case analysis study of 3772 older people admitted to the Department of Medicine for the Elderly between January and June 2005, 340 (9.0%) were from care homes, and 93 (27.3%) of the residents died during the index admission. Nearly 40% of these deaths occurred within 24h of admission indicating a high level of less appropriate admissions. Investigating eight nursing homes which admitted the highest number of patients from one primary care trust revealed that the most cited reasons for admission were the lack of advance care plans, access to General Practitioners (GPs) out of hours, as well as general access to palliative care and specialist nurses, and poor communication between patient, relatives, GPs, hospitals and care home staff. Our findings provide some useful insight into the factors that need to be addressed to avoid unnecessary or inappropriate admissions from care homes for better end of life care in aging societies.
authors.affiliation: Academic Department of Medicine for the Elderly, Level 2 East Block, Norfolk and Norwich University Hospital, and School of Medicine, Health Policy and Practice, Health and Social Sciences Research Institute, Faculty of Health, University of East Anglia, Colney Lane, Norwich NR4 7UY, UK. alice.ong@nnuh.nhs.uk
authors.forename: A C L
authors.initials: AC
authors.lastname: Ong
authors.forename: K
authors.initials: K
authors.lastname: Sabanathan
authors.forename: J F
authors.initials: JF
authors.lastname: Potter
authors.forename: P K
authors.initials: PK
authors.lastname: Myint
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D006707:Homes for the Aged / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data*; D010360:Patient Transfer / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D006113:United Kingdom / Q000453:epidemiology