Emergency department and hospital admissions among people with dementia living at home or in nursing homes: results of the European RightTimePlaceCare project on their frequency, associated factors and costs

Background: Evidence is lacking on the differences between hospitalisation of people with dementia living in nursing homes and those living in the community. The objectives of this study were: 1) to describe the frequency of hospital admission among people with dementia in eight European countries l...

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Authors: Afonso-Argilés, Francisco Javier, Meyer, Gabriele, Stephan, Astrid, Comas Serrano, Mercè, Wübker, Ansgar, Leino-Kilpi, Helena, Lethin, Connie, Saks, Kai, Soto-Martin, Maria Eugenia, Sutcliffe, Caroline, Verbeek, Hilde, Zabalegui, Adelaida, Renom-Guiteras, Anna, RightTimePlaceCare Consortium
Format: article
Status:Published version
Publication Date:2020
Country:España
Institution:Universitat Pompeu Fabra
Repository:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/47666
Online Access:http://hdl.handle.net/10230/47666
http://dx.doi.org/10.1186/s12877-020-01835-x
Access Level:Open access
Keyword:Aged
Dementia
Geriatric syndrome
Home care
Hospitalisation
Nursing home
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network_acronym_str ES
network_name_str España
repository_id_str
dc.title.none.fl_str_mv Emergency department and hospital admissions among people with dementia living at home or in nursing homes: results of the European RightTimePlaceCare project on their frequency, associated factors and costs
title Emergency department and hospital admissions among people with dementia living at home or in nursing homes: results of the European RightTimePlaceCare project on their frequency, associated factors and costs
spellingShingle Emergency department and hospital admissions among people with dementia living at home or in nursing homes: results of the European RightTimePlaceCare project on their frequency, associated factors and costs
Afonso-Argilés, Francisco Javier
Aged
Dementia
Geriatric syndrome
Home care
Hospitalisation
Nursing home
title_short Emergency department and hospital admissions among people with dementia living at home or in nursing homes: results of the European RightTimePlaceCare project on their frequency, associated factors and costs
title_full Emergency department and hospital admissions among people with dementia living at home or in nursing homes: results of the European RightTimePlaceCare project on their frequency, associated factors and costs
title_fullStr Emergency department and hospital admissions among people with dementia living at home or in nursing homes: results of the European RightTimePlaceCare project on their frequency, associated factors and costs
title_full_unstemmed Emergency department and hospital admissions among people with dementia living at home or in nursing homes: results of the European RightTimePlaceCare project on their frequency, associated factors and costs
title_sort Emergency department and hospital admissions among people with dementia living at home or in nursing homes: results of the European RightTimePlaceCare project on their frequency, associated factors and costs
dc.creator.none.fl_str_mv Afonso-Argilés, Francisco Javier
Meyer, Gabriele
Stephan, Astrid
Comas Serrano, Mercè
Wübker, Ansgar
Leino-Kilpi, Helena
Lethin, Connie
Saks, Kai
Soto-Martin, Maria Eugenia
Sutcliffe, Caroline
Verbeek, Hilde
Zabalegui, Adelaida
Renom-Guiteras, Anna
RightTimePlaceCare Consortium
author Afonso-Argilés, Francisco Javier
author_facet Afonso-Argilés, Francisco Javier
Meyer, Gabriele
Stephan, Astrid
Comas Serrano, Mercè
Wübker, Ansgar
Leino-Kilpi, Helena
Lethin, Connie
Saks, Kai
Soto-Martin, Maria Eugenia
Sutcliffe, Caroline
Verbeek, Hilde
Zabalegui, Adelaida
Renom-Guiteras, Anna
RightTimePlaceCare Consortium
author_role author
author2 Meyer, Gabriele
Stephan, Astrid
Comas Serrano, Mercè
Wübker, Ansgar
Leino-Kilpi, Helena
Lethin, Connie
Saks, Kai
Soto-Martin, Maria Eugenia
Sutcliffe, Caroline
Verbeek, Hilde
Zabalegui, Adelaida
Renom-Guiteras, Anna
RightTimePlaceCare Consortium
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Aged
Dementia
Geriatric syndrome
Home care
Hospitalisation
Nursing home
topic Aged
Dementia
Geriatric syndrome
Home care
Hospitalisation
Nursing home
description Background: Evidence is lacking on the differences between hospitalisation of people with dementia living in nursing homes and those living in the community. The objectives of this study were: 1) to describe the frequency of hospital admission among people with dementia in eight European countries living in nursing homes or in the community, 2) to examine the factors associated with hospitalisation in each setting, and 3) to evaluate the costs associated with it. Methods: The present study is a secondary data analysis of the RightTimePlaceCare European project. A cross-sectional survey was conducted with data collected from people with dementia living at home or who had been admitted to a nursing home in the last 3 months, as well as from their caregivers. Data on hospital admissions at 3 months, cognitive and functional status, neuropsychiatric symptoms, comorbidity, polypharmacy, caregiver burden, nutritional status, and falls were assessed using validated instruments. Multivariate regression models were used to investigate the factors associated with hospital admission for each setting. Costs were estimated by multiplying quantities of resources used with the unit cost of each resource and inflated to the year 2019. Results: The study sample comprised 1700 people with dementia living in the community and nursing homes. Within 3 months, 13.8 and 18.5% of people living in nursing homes and home care, respectively, experienced ≥1 hospital admission. In the nursing home setting, only polypharmacy was associated with a higher chance of hospital admission, while in the home care setting, unintentional weight loss, polypharmacy, falls, and more severe caregiver burden were associated with hospital admission. Overall, the estimated average costs per person with dementia/year among participants living in a nursing home were lower than those receiving home care. Conclusion: Admission to hospital is frequent among people with dementia, especially among those living in the community, and seems to impose a remarkable economic burden. The identification and establishment of an individualised care plan for those people with dementia with polypharmacy in nursing homes, and those with involuntary weight loss, accidental falls, polypharmacy and higher caregiver burden in the home care setting, might help preventing unnecessary hospital admissions.
publishDate 2020
dc.date.none.fl_str_mv 2020
2021
2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/47666
http://dx.doi.org/10.1186/s12877-020-01835-x
url http://hdl.handle.net/10230/47666
http://dx.doi.org/10.1186/s12877-020-01835-x
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv info:eu-repo/grantAgreement/EC/FP7/242153
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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spelling Emergency department and hospital admissions among people with dementia living at home or in nursing homes: results of the European RightTimePlaceCare project on their frequency, associated factors and costsAfonso-Argilés, Francisco JavierMeyer, GabrieleStephan, AstridComas Serrano, MercèWübker, AnsgarLeino-Kilpi, HelenaLethin, ConnieSaks, KaiSoto-Martin, Maria EugeniaSutcliffe, CarolineVerbeek, HildeZabalegui, AdelaidaRenom-Guiteras, AnnaRightTimePlaceCare ConsortiumAgedDementiaGeriatric syndromeHome careHospitalisationNursing homeBackground: Evidence is lacking on the differences between hospitalisation of people with dementia living in nursing homes and those living in the community. The objectives of this study were: 1) to describe the frequency of hospital admission among people with dementia in eight European countries living in nursing homes or in the community, 2) to examine the factors associated with hospitalisation in each setting, and 3) to evaluate the costs associated with it. Methods: The present study is a secondary data analysis of the RightTimePlaceCare European project. A cross-sectional survey was conducted with data collected from people with dementia living at home or who had been admitted to a nursing home in the last 3 months, as well as from their caregivers. Data on hospital admissions at 3 months, cognitive and functional status, neuropsychiatric symptoms, comorbidity, polypharmacy, caregiver burden, nutritional status, and falls were assessed using validated instruments. Multivariate regression models were used to investigate the factors associated with hospital admission for each setting. Costs were estimated by multiplying quantities of resources used with the unit cost of each resource and inflated to the year 2019. Results: The study sample comprised 1700 people with dementia living in the community and nursing homes. Within 3 months, 13.8 and 18.5% of people living in nursing homes and home care, respectively, experienced ≥1 hospital admission. In the nursing home setting, only polypharmacy was associated with a higher chance of hospital admission, while in the home care setting, unintentional weight loss, polypharmacy, falls, and more severe caregiver burden were associated with hospital admission. Overall, the estimated average costs per person with dementia/year among participants living in a nursing home were lower than those receiving home care. Conclusion: Admission to hospital is frequent among people with dementia, especially among those living in the community, and seems to impose a remarkable economic burden. The identification and establishment of an individualised care plan for those people with dementia with polypharmacy in nursing homes, and those with involuntary weight loss, accidental falls, polypharmacy and higher caregiver burden in the home care setting, might help preventing unnecessary hospital admissions.The RightTimePlaceCare study was supported by a grant from the European Commission within the 7th Framework Program (project 242153). The funder played no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript. Open Access funding enabled and organized by Projekt DEAL.BioMed Central202120212020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/47666http://dx.doi.org/10.1186/s12877-020-01835-xreponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésinfo:eu-repo/grantAgreement/EC/FP7/242153Copyright © The Author(s) 2020. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies tohttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/476662026-06-12T07:21:37Z
score 15.81155

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