Acute medical bed usage by nursing home residents

Area of Science:

• Geriatric Medicine
• Healthcare Management

Background:

• Rising number of elderly patients in nursing home care presenting for acute medical admission.
• Need to accurately assess the volume and characteristics of these hospital admissions.

Purpose of the Study:

• To quantify and characterize acute medical admissions from nursing home care.
• To evaluate the appropriateness of these admissions.

Main Methods:

• Survey of 1300 acute medical beds in Northern Ireland over two time points (June 1996, January 1997).
• Standardized proforma used to record demographic details, diagnosis, and length of admission.
• Analysis of patient origin (nursing home care), age, accompanying documentation, and clinical judgment on admission necessity.

Main Results:

• Identified 84 nursing home residents in June 1996 (mean age 79.5) and 125 in January 1997 (mean age 83.3).
• Nursing home residents occupied 6% of beds in June 1996, rising to 10% in January 1997.
• Only 9.6% of admissions in 1997 were judged as potentially manageable within the nursing home setting.

Conclusions:

• Nursing home residents represent a significant and growing proportion of acute medical admissions.
• The majority of these admissions are necessary, indicating a need for enhanced community medical services.
• Policy recommendations include investment in community services and acute hospital care for the elderly.