title: Transfer of nursing home residents to emergency departments: organizational differences between nursing homes with high vs. low transfer rates.
abstract: OBJECTIVE
  To explore possible factors in the organization of nursing homes that could be related to differences in the rate of transfer of residents from nursing homes to emergency department.
  
  
  METHODS
  Explorative.
  
  
  METHODS
  In a single municipality, qualitative and quantitative data were collected from documents and through semi-structured interviews with 11 RNs from five nursing homes identified as having the highest vs. six identified as having the lowest transfer rates to emergency department. Data were analysed by non-parametric tests and basic content analysis.
  
  
  RESULTS
  All nursing homes in the highest transfer rate group and one in the lowest transfer rate group were run by private for-profit providers. Compared with thelowgroup, thehighgroup had fewer updated advance care plans and the RNs interviewed had less work experience in care of older people and less training in care of persons with dementia. There was no difference in nursing home size or staff/resident ratio. The RNs described similar possibilities to provide palliative care, medical equipment and perceived medical support from GPs.
authors.affiliation: Department of Public Health and Caring Sciences Uppsala University Uppsala Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Kirsebom
authors.affiliation: Department of Public Health and Caring Sciences Uppsala University Uppsala Sweden.
authors.forename: Mariann
authors.initials: M
authors.lastname: Hedström
authors.affiliation: Department of Public Health and Caring Sciences Uppsala University Uppsala Sweden.
authors.forename: Ulrika
authors.initials: U
authors.lastname: Pöder
authors.affiliation: Department of Public Health and Caring Sciences Uppsala University Uppsala Sweden.
authors.forename: Barbro
authors.initials: B
authors.lastname: Wadensten
keywords: advance care planning; avoidable hospitalization; geriatric nursing; hospital admission; nursing homes; organization and administration