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Emergency department and hospital admissions among people with dementia living at home or in nursing homes : results of the European RightTimePlaceCare project on their frequency, associated factors and costs

Afonso-Argilés, F. Javier ; Meyer, Gabriele ; Stephan, Astrid ; Comas, Mercè ; Wübker, Ansgar ; Leino-Kilpi, Helena ; Lethin, Connie LU orcid ; Saks, Kai ; Soto-Martin, Maria and Sutcliffe, Caroline , et al. (2020) In BMC Geriatrics 20(1).
Abstract

Background: Evidence is lacking on the differences between hospitalisation of people with dementia living in nursing homes and those living in the community. The objectives of this study were: 1) to describe the frequency of hospital admission among people with dementia in eight European countries living in nursing homes or in the community, 2) to examine the factors associated with hospitalisation in each setting, and 3) to evaluate the costs associated with it. Methods: The present study is a secondary data analysis of the RightTimePlaceCare European project. A cross-sectional survey was conducted with data collected from people with dementia living at home or who had been admitted to a nursing home in the last 3 months, as well as... (More)

Background: Evidence is lacking on the differences between hospitalisation of people with dementia living in nursing homes and those living in the community. The objectives of this study were: 1) to describe the frequency of hospital admission among people with dementia in eight European countries living in nursing homes or in the community, 2) to examine the factors associated with hospitalisation in each setting, and 3) to evaluate the costs associated with it. Methods: The present study is a secondary data analysis of the RightTimePlaceCare European project. A cross-sectional survey was conducted with data collected from people with dementia living at home or who had been admitted to a nursing home in the last 3 months, as well as from their caregivers. Data on hospital admissions at 3 months, cognitive and functional status, neuropsychiatric symptoms, comorbidity, polypharmacy, caregiver burden, nutritional status, and falls were assessed using validated instruments. Multivariate regression models were used to investigate the factors associated with hospital admission for each setting. Costs were estimated by multiplying quantities of resources used with the unit cost of each resource and inflated to the year 2019. Results: The study sample comprised 1700 people with dementia living in the community and nursing homes. Within 3 months, 13.8 and 18.5% of people living in nursing homes and home care, respectively, experienced ≥1 hospital admission. In the nursing home setting, only polypharmacy was associated with a higher chance of hospital admission, while in the home care setting, unintentional weight loss, polypharmacy, falls, and more severe caregiver burden were associated with hospital admission. Overall, the estimated average costs per person with dementia/year among participants living in a nursing home were lower than those receiving home care. Conclusion: Admission to hospital is frequent among people with dementia, especially among those living in the community, and seems to impose a remarkable economic burden. The identification and establishment of an individualised care plan for those people with dementia with polypharmacy in nursing homes, and those with involuntary weight loss, accidental falls, polypharmacy and higher caregiver burden in the home care setting, might help preventing unnecessary hospital admissions.

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author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Aged, Dementia, Geriatric syndrome, Home care, Hospitalisation, Nursing home
in
BMC Geriatrics
volume
20
issue
1
article number
453
publisher
BioMed Central (BMC)
external identifiers
  • pmid:33153444
  • scopus:85095447875
ISSN
1471-2318
DOI
10.1186/s12877-020-01835-x
language
English
LU publication?
yes
id
d32f8865-414b-4d78-8f72-d517e3994536
date added to LUP
2020-11-13 10:11:32
date last changed
2024-05-29 22:57:16
@article{d32f8865-414b-4d78-8f72-d517e3994536,
  abstract     = {{<p>Background: Evidence is lacking on the differences between hospitalisation of people with dementia living in nursing homes and those living in the community. The objectives of this study were: 1) to describe the frequency of hospital admission among people with dementia in eight European countries living in nursing homes or in the community, 2) to examine the factors associated with hospitalisation in each setting, and 3) to evaluate the costs associated with it. Methods: The present study is a secondary data analysis of the RightTimePlaceCare European project. A cross-sectional survey was conducted with data collected from people with dementia living at home or who had been admitted to a nursing home in the last 3 months, as well as from their caregivers. Data on hospital admissions at 3 months, cognitive and functional status, neuropsychiatric symptoms, comorbidity, polypharmacy, caregiver burden, nutritional status, and falls were assessed using validated instruments. Multivariate regression models were used to investigate the factors associated with hospital admission for each setting. Costs were estimated by multiplying quantities of resources used with the unit cost of each resource and inflated to the year 2019. Results: The study sample comprised 1700 people with dementia living in the community and nursing homes. Within 3 months, 13.8 and 18.5% of people living in nursing homes and home care, respectively, experienced ≥1 hospital admission. In the nursing home setting, only polypharmacy was associated with a higher chance of hospital admission, while in the home care setting, unintentional weight loss, polypharmacy, falls, and more severe caregiver burden were associated with hospital admission. Overall, the estimated average costs per person with dementia/year among participants living in a nursing home were lower than those receiving home care. Conclusion: Admission to hospital is frequent among people with dementia, especially among those living in the community, and seems to impose a remarkable economic burden. The identification and establishment of an individualised care plan for those people with dementia with polypharmacy in nursing homes, and those with involuntary weight loss, accidental falls, polypharmacy and higher caregiver burden in the home care setting, might help preventing unnecessary hospital admissions.</p>}},
  author       = {{Afonso-Argilés, F. Javier and Meyer, Gabriele and Stephan, Astrid and Comas, Mercè and Wübker, Ansgar and Leino-Kilpi, Helena and Lethin, Connie and Saks, Kai and Soto-Martin, Maria and Sutcliffe, Caroline and Verbeek, Hilde and Zabalegui, Adelaida and Renom-Guiteras, Anna}},
  issn         = {{1471-2318}},
  keywords     = {{Aged; Dementia; Geriatric syndrome; Home care; Hospitalisation; Nursing home}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Geriatrics}},
  title        = {{Emergency department and hospital admissions among people with dementia living at home or in nursing homes : results of the European RightTimePlaceCare project on their frequency, associated factors and costs}},
  url          = {{http://dx.doi.org/10.1186/s12877-020-01835-x}},
  doi          = {{10.1186/s12877-020-01835-x}},
  volume       = {{20}},
  year         = {{2020}},
}