title: Factors associated with increased hospitalisation risk among nursing home residents in Sweden: a prospective study with a three-year follow-up.
abstract: BACKGROUND
  Hospitalisation of nursing home residents might lead to deteriorating health.
  
  
  OBJECTIVE
  To evaluate physical and psychological factors associated with hospitalisation risk among nursing home residents.
  
  
  METHODS
  Prospective study with three years of follow-up.
  
  
  METHODS
  Four hundred and twenty-nine Swedish nursing home residents, ages 65-101 years, from 11 nursing homes in three municipalities were followed during three years. The participants' physical and psychological status was assessed at baseline. A Cox proportional hazards model was used to evaluate factors associated with hospitalisation risk using STATA.
  
  
  RESULTS
  Of the 429 participants, 196 (45.7%) were hospitalised at least once during the three-year follow-up period, and 109 (25.4%) during the first six months of the study. The most common causes of hospitalisation were cardiovascular diseases or complications due to falls. A Cox regression model showed that residents who have had previous falls (P < 0.001), are malnourished (P < 0.001), use a greater number of drugs (P < 0.001) and have more diseases (P < 0.001), are at an increased risk of hospitalisation.
  
  
  CONCLUSIONS
  Nursing home residents are frequently hospitalised, often due to falls or cardiovascular diseases. Study results underscore the relationships between malnutrition, previous falls, greater numbers of drugs and diseases and higher risk of hospitalisation.
  
  
  CONCLUSIONS
  Preventive interventions aimed at malnutrition and falls at the nursing home could potentially reduce the number of hospitalisations. With improved education and support to nurses concerning risk assessment at the nursing homes, it may be possible to reduce the numbers of avoidable hospitalisation among nursing home residents and in the long run improve quality of life and reduce suffering.
authors.affiliation: Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden.|Regional Development Council of Jönköping County, Jönköping, Sweden.
authors.forename: Jenny
authors.initials: J
authors.lastname: Hallgren
authors.affiliation: Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Ernsth Bravell
authors.affiliation: Department of Clinical Sciences, Lund University, Malmö, Sweden.
authors.forename: Sigvard
authors.initials: S
authors.lastname: Mölstad
authors.affiliation: Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: Carl Johan
authors.initials: CJ
authors.lastname: Östgren
authors.affiliation: Department of Clinical Sciences, Lund University, Malmö, Sweden.
authors.forename: Patrik
authors.initials: P
authors.lastname: Midlöv
authors.affiliation: Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden.|Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Anna K
authors.initials: AK
authors.lastname: Dahl Aslan
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000453:epidemiology; D009735:Nursing Homes; D019338:Polypharmacy; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
keywords: hospitalization; nursing home residents; preventive care; prospective design