+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Hospital admission of nursing home patients considered but not carried out: role of the nursing home physician and the involved parties and various differences with realized hospital admissions

Hospital admission of nursing home patients considered but not carried out: role of the nursing home physician and the involved parties and various differences with realized hospital admissions

Tijdschrift Voor Gerontologie en Geriatrie 27(5): 197-205

The objective of the study was to establish in which way nursing home patients, for whom is refrained from hospitalization, differ from hospitalized nursing home patients. The question was also raised of how the decision to refrain from hospitalization is taken: which point of view and method the nursing home physician has, on which arguments decisions are based and which parties are involved and in which way. The design of the study was retrospective and descriptive. Data obtained from semi-structured interviews held in 1987 with 24 nursing home physicians on 45 situations were compared with registration data on 387 hospitalizations of patients from 30 nursing homes. In the non-hospitalized patients malignancies were relatively more frequent than in the hospitalized patients (29% versus 7%). The mean age of hospitalized patients was 78 and of non-hospitalized patients 80 years. The physical condition of non-hospitalized patients was more frequently judged as poor and the life expectancy as more limited. Already at an early stage nursing home physicians appeared to have a point of view, with which they determined the decision making procedure: in favour of (40%), opposing (35%) and in doubt of hospitalization (25%). In 'non-hospitalizations' there was much more involvement in decision making of family members and nurses, and less involvement of patients and medical specialists than in decisions to hospitalization. Non-medical arguments opposing hospitalization had slightly the upper hand above medical arguments. The decisive arguments opposing hospitalization were in the case of psychogeriatric patients more often of medical origin than in the case of somatic patients. The 'quality of live' mentioned arguments were of limited importance. The nursing home physician needs good communicative qualities in such decision making processes. He has to be skilled to judge competency of patients and, if needed, to balance in the right way the information of relatives, nurses, colleagues and specialists.

Please choose payment method:

(PDF emailed within 1 workday: $29.90)

Accession: 046269856

Download citation: RISBibTeXText

PMID: 8966747

Related references

Case mix and outcomes of nursing home patients. The importance of prior nursing home care and admission from home versus hospital. Medical Care 27(4): 376-385, 1989

Hospital in the nursing home. Treating acute hospital problems in nursing home residents using a Hospital in the Home model. Australian Family Physician 30(10): 1010-1012, 2001

Hospital admission of nursing home patients: patient characteristics and purpose of admission. Nederlands Tijdschrift Voor Geneeskunde 138(53): 2655-2659, 1994

Medicare Home Visit Program Associated With Fewer Hospital And Nursing Home Admissions, Increased Office Visits. Health Affairs 34(12): 2138-2146, 2017

Predictors of nursing home placement and home nursing services utilization by elderly patients after hospital discharge in Taiwan. Journal of Advanced Nursing 38(4): 398-406, 2002

Who decides on hospital admission of nursing home patients?. Nederlands Tijdschrift Voor Geneeskunde 138(53): 2660-2664, 1994

From nursing home to hospital and back again: an educational program to improve care for hospitalized nursing home patients. Journal for Nurses in Staff Development 19(3): 113-8; Quiz 119-20, 2003

Effects of a nursing home visit on state hospital patients' attitudes toward nursing home placement. Journal of Geriatric Psychiatry 7(1): 122-133, 1973

Hospital admission of nursing home patients: a difficult decision?. Nederlands Tijdschrift Voor Geneeskunde 138(53): 2664-2668, 1994

Reported expectations for nursing home placement among older adults and their role as risk factors for nursing home admissions. Gerontologist 46(4): 464-473, 2006

Nursing home patients common pathogens isolated on admission to the hospital. Abstracts of the General Meeting of the American Society for Microbiology 91: 430, 1991

Prevalence of pressure ulcers on hospital admission among nursing home residents transferred to the hospital. Wound Repair and Regeneration 16(3): 331-336, 2008

Appropriateness of patient transfer from a nursing home to an acute care hospital a study of emergency room visits and hospital admissions. Journal of the American Geriatrics Society 39(12): 1164-1168, 1991

Appropriateness of Patient Transfer from a Nursing Home to an Acute-Care Hospital: A Study of Emergency Room Visits and Hospital Admissions. Journal of the American Geriatrics Society 39(12): 1164-1168, 1991

Hospital nurse's experience with job rotation between home care nursing and hospital nursing in Horsens: one makes entirely different patient contacts than in the hospital. Sygeplejersken 80(45): 4-5, 1980