Lienesch Paula, Rothgang Heinz, Gerhardus Ansgar, Wolf-Ostermann Karin, Hoffmann Falk, Czwikla Jonas
Department of Health, Long-Term Care and Pensions, SOCIUM Research Center On Inequality and Social Policy, University of Bremen, Mary-Somerville-Straße 5, Bremen, 28359, Germany.
High-Profile Area of Health Sciences, University of Bremen, Bibliothekstraße 1, Bremen, 28359, Germany.
BMC Health Serv Res. 2025 Feb 1;25(1):194. doi: 10.1186/s12913-025-12342-3.
Nursing home residents frequently utilize medical care, but there lacks a complete picture of their acute medical care utilization. We quantified hospitalizations, emergency medical care utilization, and contacts with the regional on-call medical services among nursing home residents, and investigated individual characteristics that may be associated with the utilization of these medical care types.
Cross-sectional data from the "Needs-based provision of medical care to nursing home residents" (MVP-STAT) study were analyzed, which were collected in 44 German nursing homes from 442 residents in 2018/2019. Proportions of residents with at least one hospitalization, emergency medical care utilization (via the nationwide phone number 112), and contact with an on-call medical service (nationwide via 116117) over the previous 12 months were determined. Associations between individual characteristics and the utilization of the three medical care types were examined using multivariable logistic regressions.
Of the analyzed residents, 45.8% were hospitalized, 23.2% utilized emergency medical care, and 12.1% had contact with an on-call medical service at least once in the previous 12 months. Hospitalizations were positively associated with male vs. female sex (adjusted odds ratio 1.99 [95% confidence interval 1.22-3.26]), age group 85 + vs. 60-74 years (2.15 [1.12-4.13]), long-term care grades 4/5 vs. 1/2 (2.78 [1.48-5.21]), 6 + vs. 0-1 Elixhauser diseases (2.58 [1.01-6.62]), and the risk or presence of vs. no malnutrition (3.10 [1.52-6.35] and 2.01 [1.26-3.21]); and not associated with years of residence in the respective nursing home. Emergency medical care utilization was positively associated with age group 85 + vs. 60-74 years (2.58 [1.14-5.84]) and long-term care grades 3 and 4/5 vs. 1/2 (2.65 [1.07-6.55], 6.31 [2.60-15.35]); negatively associated with 5 + vs. 1- < 3 years of residence (0.46 [0.24-0.86]); and not associated with sex, the number of Elixhauser diseases, and nutritional status. No associations were found with on-call medical services.
Hospitalizations and emergency medical care utilization were more frequent among nursing home residents than contacts with on-call medical services. Future studies should investigate whether the frequent hospitalizations and emergency medical care utilization among nursing home residents are justified, or whether they can be reduced by strengthening medical care provision by on-call doctors and other professionals.
DRKS00012383 [2017/12/06].
疗养院居民经常使用医疗服务，但缺乏他们急性医疗服务利用情况的全貌。我们对疗养院居民的住院情况、紧急医疗服务利用情况以及与地区值班医疗服务的接触情况进行了量化，并调查了可能与这些医疗服务类型利用相关的个体特征。
分析了“基于需求为疗养院居民提供医疗服务”（MVP-STAT）研究的横断面数据，这些数据于2018/2019年在德国44家疗养院的442名居民中收集。确定了在过去12个月内至少有一次住院、使用紧急医疗服务（通过全国电话号码112）以及与值班医疗服务接触（通过全国电话116117）的居民比例。使用多变量逻辑回归分析个体特征与三种医疗服务类型利用之间的关联。
在分析的居民中，45.8%的人住院，23.2%的人使用了紧急医疗服务，12.1%的人在过去12个月内至少与值班医疗服务接触过一次。住院与男性性别相比女性（调整后的优势比1.99 [95%置信区间1.22 - 3.26]）、85岁及以上年龄组与60 - 74岁年龄组（2.15 [1.12 - 4.13]）、长期护理等级4/5与1/2（2.78 [1.48 - 5.21]）、6种及以上与0 - 1种埃利克斯豪泽疾病（2.58 [1.01 - 6.62]）以及存在营养不良风险或患有营养不良与未患营养不良（3.10 [1.52 - 6.35]和2.01 [1.26 - 3.21]）呈正相关；与在各自疗养院的居住年限无关。紧急医疗服务利用与85岁及以上年龄组与60 - 74岁年龄组（2.58 [1.14 - 5.84]）以及长期护理等级3和4/5与1/2（2.65 [1.07 - 6.55]，6.31 [2.60 - 15.35]）呈正相关；与居住5年及以上与居住1 - 不足3年呈负相关（0.46 [0.24 - 0.86]）；与性别、埃利克斯豪泽疾病数量和营养状况无关。未发现与值班医疗服务有关联。
疗养院居民的住院和紧急医疗服务利用比与值班医疗服务的接触更为频繁。未来的研究应调查疗养院居民频繁住院和使用紧急医疗服务是否合理，或者是否可以通过加强值班医生和其他专业人员的医疗服务提供来减少。
DRKS00012383 [2017/12/06]
