Division of Outpatient Care and Pharmacoepidemiology, Department of Health Services Research, School VI - School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg, Lower Saxony, Germany.
Department of Primary and Long-Term Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Eur Geriatr Med. 2024 Jun;15(3):787-795. doi: 10.1007/s41999-024-00975-2. Epub 2024 Apr 29.
Assessing and comparing German and Dutch nursing home perspectives on residents' hospital transfers.
Cross-sectional study among German and Dutch nursing homes. Two surveys were conducted in May 2022, each among 600 randomly selected nursing homes in Germany and the Netherlands. The questionnaires were identical for both countries. The responses were compared between the German and Dutch participants.
We received 199 German (response: 33.2%) and 102 Dutch questionnaires (response: 17.0%). German nursing homes estimated the proportion of transfers to hospital during 1 year to be higher than in Dutch facilities (emergency department visits: 26.5% vs. 7.9%, p < 0.0001; hospital admissions: 29.5% vs. 10.5%, p < 0.0001). In German nursing homes, the proportion of transfers to hospital where the decision was made by the referring physician was lower than in the Dutch facilities (58.8% vs. 88.8%, p < 0.0001). More German nursing homes agreed that nursing home residents are transferred to the hospital too frequently (24.5% vs. 10.8%, p = 0.0069). German nursing homes were much more likely than Dutch facilities to believe that there was no alternative to transfer to a hospital when a nursing home resident had a fall (66.3% vs. 12.8%, p < 0.0001).
German nursing home residents are transferred to hospital more frequently than Dutch residents. This can probably be explained by differences in the care provided in the facilities. Future studies should, therefore, look more closely at these two systems and examine the extent to which more intensive outpatient care can avoid transfers to hospital.
评估和比较德国和荷兰养老院对居民住院转院的看法。
对德国和荷兰养老院进行横断面研究。2022 年 5 月分别对两国的 600 家随机选定的养老院进行了两次调查。两国的调查问卷是相同的。对德国和荷兰参与者的回答进行了比较。
我们收到了 199 份德国（回应率：33.2%）和 102 份荷兰问卷（回应率：17.0%）。德国养老院估计在 1 年内转往医院的比例高于荷兰养老院（急诊就诊：26.5%对 7.9%，p<0.0001；住院：29.5%对 10.5%，p<0.0001）。在德国养老院，由转诊医生决定转往医院的比例低于荷兰养老院（58.8%对 88.8%，p<0.0001）。更多的德国养老院认为养老院居民转往医院过于频繁（24.5%对 10.8%，p=0.0069）。德国养老院比荷兰养老院更倾向于认为当养老院居民摔倒时，没有其他选择只能转往医院（66.3%对 12.8%，p<0.0001）。
与荷兰居民相比，德国养老院居民更频繁地转往医院。这可能是由于设施提供的护理存在差异所致。未来的研究应更仔细地研究这两个系统，并研究更密集的门诊护理在多大程度上可以避免转往医院。
