title: Appropriateness of unscheduled hospital admissions from care homes.
abstract: Unscheduled hospital admissions from care homes are common and potentially avoidable but little guidance is available as to what constitutes an appropriate hospital admission. We surveyed healthcare professionals' opinions on a range of common scenarios affecting care-home residents. We developed seven clinical vignettes and an accompanying questionnaire. We used purposive sampling to obtain opinions from relevant primary care and secondary care teams. We asked assessors to comment on whether they would favour hospital admission and to justify their response using pre-selected options and/or free text. Admission to hospital was judged inappropriate in 54.6% of responses. Opinion on admission varied according to the case, with fewer than half of respondents agreeing for three of the seven cases. Recurring themes were uncertainty around services available to care homes and anticipatory care planning. The lack of consensus suggests that concepts surrounding inappropriate care-home admission are not shared by staff who provide care for this patient group.
authors.affiliation: Centre for Cognitive Ageing and Cognitive Epidemiology and the Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK jenni.harrison@ed.ac.uk.
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Harrison
authors.affiliation: Thistle Healthcare, UK.
authors.forename: Iona K
authors.initials: IK
authors.lastname: McKay
authors.affiliation: Emergency Department, Western Infirmary, Glasgow, UK.
authors.forename: Patrick
authors.initials: P
authors.lastname: Grant
authors.affiliation: NHS Greater Glasgow and Clyde, Glasgow, UK.
authors.forename: Jean
authors.initials: J
authors.lastname: Hannah
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK;
authors.forename: Terence J
authors.initials: TJ
authors.lastname: Quinn
mesh_terms: D000368:Aged; D006282:Health Personnel / Q000706:statistics & numerical data*; D006300:Health Services Misuse; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: Care home; hospitalisation; nursing homes; questionnaire