Centre for Age-related Medicine, Stavanger University Hospital, Norway.
Scand J Public Health. 2013 Jun;41(4):366-73. doi: 10.1177/1403494813484398. Epub 2013 Apr 12.
Nursing home residents represent a frail and multimorbid group of patients. The rationality of the hospitalisation of nursing home patients has therefore been questioned.
To investigate hospital referrals of nursing home patients in the municipality of Stavanger, Norway and identify the number of inappropriate referrals and costs.
The number of referrals was retrospectively identified by the emergency dispatch centre in the 18 municipalities of South Rogaland in 2011. For the municipality of Stavanger, referring instance, reason for referral, purpose of referral, the existence of an advance care plan, and appropriateness were assessed. Total costs and costs for inappropriate referrals were estimated.
In Stavanger there were 0.38 hospital referrals per nursing home bed per year as compared to 0.60 in the surrounding municipalities. Of 359 referrals, 78.6% resulted in an in-hospital stay, in-hospital mortality rate was 7.8%, and 7% were assessed as being inappropriate. The costs per referral were estimated to be €6198.
Stavanger had a lower referral rate than the surrounding municipalities. The results also show that the in-hospital mortality rate and the share of inappropriate referrals were low compared to other studies in the field. Further research is needed in order to evaluate which interventions are effective in improving medical care at nursing homes and thus reduce referral rates.
养老院居民是一个脆弱且多病的群体。因此，养老院患者住院的合理性受到了质疑。
调查挪威斯塔万格市养老院患者的住院转介情况，并确定不适当转介的数量和成本。
通过南罗加兰 18 个市的紧急调度中心，回顾性确定 2011 年的转介数量。针对斯塔万格市的转介情况，评估了转介原因、转介目的、是否存在预先护理计划以及是否适当。还估算了总费用和不适当转介的费用。
斯塔万格市每 100 张养老院床位每年的医院转介率为 0.38，而周边城市为 0.60。359 例转介中，78.6%导致住院，住院死亡率为 7.8%，7%被评估为不适当。估计每次转介的费用为 6198 欧元。
斯塔万格的转介率低于周边城市。结果还表明，与该领域的其他研究相比，住院死亡率和不适当转介的比例较低。需要进一步研究，以评估哪些干预措施可有效改善养老院的医疗服务，从而降低转介率。
