Study Highlights: Hospitalizations and ED visits among nursing home residents
- Up to 40% of nursing home hospital transfers over the past 25 years are considered potentially avoidable.
- These avoidable transfers cost Medicare an estimated $14.3 billion annually.
- 1 in 3 severely impaired residents were hospitalized; over one-third of those hospitalizations were deemed avoidable.
- Nearly 20% had ED visits without admission; 70% of those were preventable.
- Among terminally ill residents, 80% of ED visits were considered avoidable.
BOCA RATON, Fla. — Hospitalizations and emergency department (ED) visits can be especially distressing and costly for nursing home residents, particularly those who are severely impaired or terminally ill. Yet up to 40% of these transfers over the past 25 years may have been avoidable, according to a study by Florida Atlantic University.
Unnecessary transfers often result in added discomfort for residents and families, increase the risk of hospital-related complications and drive up costs, contributing an estimated $14.3 billion annually to Medicare spending in the U.S., according to the study.
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In one of the largest studies of its kind, researchers from Florida Atlantic University’s Schmidt College of Medicine and Christine E. Lynn College of Nursing, along with collaborators, analyzed data from 264 nursing homes nationwide to explore the drivers behind hospital transfers.
Using data from a randomized trial of the Interventions to Reduce Acute Care Transfers (INTERACT) program, the study pinpointed the medical conditions most commonly associated with hospitalizations, emergency department visits and potentially avoidable transfers among severely impaired and terminally ill nursing home residents.
A study of over 6,000 severely impaired nursing home residents found that one in three were hospitalized, with more than a third of those stays considered avoidable. Among terminally ill residents, emergency department visits were less frequent, but 80% were potentially unnecessary.
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In the severely impaired group, feeding tube issues, like blockages, dislodgement or infections, were the top reason for hospital visits. Among terminally ill residents, trauma from falls was a leading and often preventable cause.
The study also identified common diagnoses linked to potentially avoidable hospitalizations. For severely impaired residents, urinary tract infections (UTIs), seizures and low blood pressure were most frequent. UTIs, in particular, are often overdiagnosed in nursing homes despite clear treatment guidelines.
For terminally ill residents, pneumonia, UTIs, kidney failure and heart failure were the leading causes of avoidable hospitalizations. Breathing issues, infections and altered mental status were common across both groups.
How often do you encounter nursing home transfers that you believe could have been avoided with better on-site care or planning?
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