title: [Hospital emergencies arising from nursing homes in a region: evolution, characteristics and appropriateness].
abstract: OBJECTIVE
  Hospital emergencies (HE) arising from nursing homes (NH) are on the rise. We analyse the evolution, characteristics and appropriateness of HE of NH residents in a region, as well as resulting hospital admissions.
  
  
  METHODS
  Retrospective descriptive study between 2010 and 2013 of institutionalised residents of 11 NH located in Baix Empordà (704 beds) and Palamós Hospital.
  
  
  METHODS
  Gender, age, morbidity and relative weight according to clinical risk groups (CRG), NH, length of stay, diagnosis of the emergency, appropriateness of HE according to Bermejo's criteria and the HE appropriateness protocol (HEAP), and appropriateness of hospitalisations according to the Appropriateness Evaluation Protocol (AEP). Sample to evaluate appropriateness: 159 HE and 91 hospitalisations.
  
  
  METHODS
  frequency, mean, standard deviation, percentiles, Fisher's exact test and ANOVA, with a confidence interval of 95% and using IBM SPSS Statistics 23.
  
  
  RESULTS
  1,474 people were enrolled, of which 73% were women. Group ≥85 years increased to 60.3% and the mean weight of morbidity was 3.2 to 4.0 (p <0.001). 1,805 HE were generated. The annual rate per 1,000 stays arising from NH increased from 1.64 to 2.05, of which 90.6% were appropriate according to Bermejo's criteria and 93.7% according to the HEAP. Of these, 502 involved hospitalisation. The annual rate per 10 emergencies fell from 2.96 to 2.64 and 98.9% were appropriate according to the AEP.
  
  
  CONCLUSIONS
  Hospital emergencies and hospitalisations of NH residents are increasing and are appropriate. Increasing age and disease burden could explain this phenomenon. NH and hospitals should react appropriately, considering the specific needs of this population sector.
authors.affiliation: Grup de Recerca en Serveis Sanitaris i Resultats en Salut (GRESSIRES), Serveis de Salut Integrats Baix Empordà (SSIBE), Palamós (Girona), España. Electronic address: isanchezp@ssibe.cat.
authors.forename: Inma
authors.initials: I
authors.lastname: Sánchez-Pérez
authors.affiliation: Centro Sociosanitario Palamós Gent Gran, Serveis de Salut Integrats Baix Empordà (SSIBE), Palamós (Girona), España.
authors.forename: Nuri
authors.initials: N
authors.lastname: Comes Garcia
authors.affiliation: Residencia Asistida y Centro de Día Sant Feliu de Guíxols Gent Gran, Fundació Guíxols Surís, Sant Feliu de Guíxols (Girona), España.
authors.forename: Lola
authors.initials: L
authors.lastname: Romero Piniella
authors.affiliation: Residencia Asistida y Centro de Día Palafrugell Gent Gran, Fundació Palafrugell Gent Gran, Palafrugell (Girona), España.
authors.forename: Gemma
authors.initials: G
authors.lastname: Prats Martos
authors.affiliation: Servicio de Urgencias, Hospital de Palamós, Serveis de Salut Integrats Baix Empordà (SSIBE), Palamós (Girona), España.
authors.forename: Gemma
authors.initials: G
authors.lastname: Arnau Bataller
authors.affiliation: Grup de Recerca en Serveis Sanitaris i Resultats en Salut (GRESSIRES), Serveis de Salut Integrats Baix Empordà (SSIBE), Palamós (Girona), España.
authors.forename: Jordi
authors.initials: J
authors.lastname: Coderch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004630:Emergencies / Q000453:epidemiology*; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009735:Nursing Homes; D010343:Patient Admission / Q000706:statistics & numerical data; D012040:Regional Health Planning; D012189:Retrospective Studies; D012306:Risk; D013030:Spain / Q000453:epidemiology
keywords: Ancianos; Emergencies; Emergency Service, Hospital; Hospitalización; Hospitalization, Aged; Instituciones residenciales; Nursing homes; Residencias geriátricas; Residential facilities; Servicio de urgencia en hospital; Urgencias médicas