Nearly 60% of Nursing Home Hospitalizations Avoidable

Hospitalizations are common among long-term stay nursing home residents, but a recent study finds that identifying and addressing the relationship between clinical risk factors, facility characteristics, and state policies can help avoid a majority of resident trips to the hospital.

Analyzing a sample population of residents in 10% of certified nursing homes in the U.S., researchers published in Medical Care‘s August 2013 publication found that three-fifths of hospitalizations were potentially avoidable. 

The study measured hospitalization risk using three measures, including ambulatory care-sensitive conditions, additional nursing home-senstive avoidable conditions and nursing home “unavoidable” conditions. 

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In all three models, researchers included clinical risk factors, nursing home facility characteristics, along with state policy variables that may influence the decision to hospitalize.

Additionally, researchers also noted that the majority of these preventable hospitalizations among nursing home residents were for infections, injuries and congestive heart failure.

Clinical risk factors contributing to hospitalization levels included renal disease, diabetes, as well as a high number of medications among other residents. 

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Staffing, quality and reimbursement were found to affect avoidable, but not unavoidable hospitalizations. Identifying risk factors and their relationship to state policies and facility characteristics may help cut down on avoidable hospitalizations, the researchers say. 

“A nursing home-sensitive measure of avoidable hospitalizations identifies both clinical facility and policy risk factors, emphasizing the potential for both reimbursement and clinical strategies to reduce hospitalizations from nursing homes,” researchers concluded. 

View the study abstract.

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Written by Jason Oliva