Impact of regular televisits on unplanned hospital admissions of nursing home residents in rural Germany: a pre-post intervention study.

BACKGROUND

Hospital admissions occur frequently in nursing homes and are often preventable. Inappropriate hospitalisations due to nursing home-sensitive conditions pose significant risks to residents, place additional strain on emergency departments and hospitals, and thus lead to substantial healthcare costs. In light of demographic changes- characterised by an aging and increasingly multimorbid nursing home population- combined with ubiquitous lack of health care professionals, new strategies are urgently needed to ensure adequate medical care in nursing homes. Telemedicine presents a promising and innovative solution, particularly for rural regions, to improve access to timely medical attention. In this study, we evaluated whether the implementation of regular televisits, in addition to on-site visits, can help decrease unplanned hospitalisations.

METHODS

In 2021, a nursing home in rural Germany introduced televisits with a cooperating general practitioner. Data on unplanned hospital admissions was collected for the years 2021/22 and 2018/19, the latter serving as a pre-intervention comparison. Hospital admissions were then compared between the two time periods, as well as between residents of 2021/22 who did or did not receive regular televisits.

RESULTS

Baseline characteristics were comparable between residents of 2018 and 2021, as well as between residents in the telemedical care and the control group. Unplanned hospital admissions significantly decreased (P <.0001) after implementation of regular televisits. Furthermore, a significantly lower (P =.04) number of hospital admissions was noted among residents in 2021/22 who received additional regular televisits, compared to the control group of residents that only received regular on-site visits.

CONCLUSIONS

Implementing regular televisits in the nursing home setting reduced the number of hospital admissions. This is most likely due to more frequent medical assessment, enabling early detection and timely management of deteriorations. By preventing unnecessary hospital admissions residents were spared the physical and psychological burdens connected with emergency transfers and protected from hospital-associated risks. On top of enhancing quality of care for the residents, televisits implementation in nursing homes can contribute to decrease strain on emergency services and hospitals.

TRIAL REGISTRATION

Not applicable, as no health-related intervention, modifying biomedical outcome or health-related measures in patients, took place.