title: [Evaluation of an intervention program in nursing homes to reduce hospital attendance].
abstract: OBJECTIVE
  This study describes the outcomes of an intervention program in Nursing Homes and their effects on emergency room attendance, hospital admissions, and pharmaceutical expenditure.
  
  
  METHODS
  This involved non-randomised community intervention in Nursing Homes with a control group. The program was implemented gradually from 2007 to 2009 in 10 Nursing Homes (857 beds) which participated voluntarily. The control group consisted of 14 Nursing homes (1,200 beds), which refused to participate or were not assigned to our Primary Care centres. Intervention consisted of comprehensive geriatric assessment and follow-up visits by trained personnel, review and adjustment of drug treatment, case management and staff training.
  
  
  RESULTS
  In the Nursing Homes where the program was carried out, emergency room attendance decreased from 1165‰ (95%CI 1100-1240]) in 2006 to 674‰ (95%CI 620-730) in 2009, while in the control group it increased from 1071 (95%CI 1020-1130) to 1246‰ (95%CI 1190-1310). The hospital admissions also decreased from 48.4% (95%CI 45-52) in 2006 to 32.1% (95%CI 29-35) in 2009, while in the control group increased from 43.5% (95%CI 41-46) to 55.8% (95%CI 53-59). There was also a 9% reduction in pharmacy cost compared with an increase of 11.9% in the control group.
  
  
  CONCLUSIONS
  The intervention has proved effective at reducing hospital admissions and emergency room attendance in institutionalised patients, thereby streamlining pharmacy costs.
authors.affiliation: Servicio de Atención Domiciliaria, Corporació de Salut del Maresme i La Selva, Calella, Barcelona, España. M. Díaz-Gegúndez
authors.forename: Mercedes
authors.initials: M
authors.lastname: Díaz-Gegúndez
authors.forename: Guillem
authors.initials: G
authors.lastname: Paluzie
authors.forename: Carme
authors.initials: C
authors.lastname: Sanz-Ballester
authors.forename: Mercè
authors.initials: M
authors.lastname: Boada-Mejorana
authors.forename: Susanna
authors.initials: S
authors.lastname: Terré-Ohme
authors.forename: Dolors
authors.initials: D
authors.lastname: Ruiz-Poza
mesh_terms: D000368:Aged; D019090:Case Management; D054869:Clinical Audit; D004358:Drug Therapy / Q000191:economics; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D015577:Geriatric Assessment; D006282:Health Personnel / Q000193:education; D006707:Homes for the Aged / Q000592:standards*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D009735:Nursing Homes / Q000592:standards*