Nearly half of long-stay nursing home residents are transferred to a hospital emergency department (ED) at least once a year, but only a third of those patients were admitted to the hospital, a study published in the Journal of Post-Acute and Long-Term Care Medicine found.
The amount of time before a nursing home patient was sent to the ED was influenced by age, race, the number of hospitalizations in the previous year, having two or more chronic diseases and their "do not resuscitate" status, researchers from Indiana University said in an announcement about their study.
"Nursing home providers should be aware of these factors when developing strategies that meet patient care goals and avoid transfer from the nursing home to the ED," the researchers concluded. Whether the patients had dementia and the severity of dementia did not influence how likely they were to be transferred to the ED or hospitalized after transfer, the researchers said.
Primary author Michael LaMantia, M.D., of IU School of Medicine, said in the announcement that providers should ask why patients with advanced dementia are sent for stressful, potentially disorienting ED treatment as frequently as less cognitively impaired patients when their families generally request comfort-oriented care. Both doctors and nursing home staff, he said, "should be thinking about why individuals with advanced dementia ... have ED utilization patterns similar to those patients with early to moderate dementia and even those with no dementia."