Predictors of Hospitalization in Italian Nursing Home Residents: The U.L.I.S.S.E. Project

Journal of the American Medical Directors Association

Volumn 13, Issue 1, 2012, Pages 84.e5-84.e10

  Cherubini, Antonio ^a   Eusebi, Paolo ^b   Dell'Aquila, Giuseppina ^a   Landi, Francesco ^c   Gasperini, Beatrice ^a   Bacuccoli, Roberta ^d   Menculini, Giuseppe ^a   Bernabei, Roberto ^c   Lattanzio, Fabrizia ^e   Ruggiero, Carmelinda ^a  

^a UNIVERSITY OF PERUGIA   (Italy)

^b Regional Health Authority of Umbria   (Italy)

^c CATHOLIC UNIVERSITY   (Italy)

^d UNIVERSITY OF FLORENCE   (Italy)

^e INRCA   (Italy)

Author keywords

Arrhythmia; Gender; Hospitalization; Nursing homes; Polypharmacy; Staffing; Urinary tract infection

Indexed keywords

AGED; ARTICLE; ELDERLY CARE; FEMALE; FOLLOW UP; GERIATRIC ASSESSMENT; HEALTH CARE QUALITY; HEART ARRHYTHMIA; HOSPITAL ADMISSION; HOSPITALIZATION; HUMAN; ITALY; LONGITUDINAL STUDY; MAJOR CLINICAL STUDY; MALE; NURSE; NURSING HOME; NURSING HOME PATIENT; OBSERVATIONAL STUDY; PHYSICIAN; POLYPHARMACY; PREDICTION; QUESTIONNAIRE; SELF REPORT; URINARY TRACT INFECTION;

EID: 84855186989     PISSN: 15258610     EISSN: 15389375     Source Type: Journal    
DOI: 10.1016/j.jamda.2011.04.001     Document Type: Article

References (60)

1. Tolson D., Rolland Y., Andrieu S., et al. The International Association of Gerontology and Geriatrics/World Health Organization/Society Française de Gérontologie et de Gériatrie Task Force. International association of gerontology and geriatrics: a global agenda for clinical research and quality of care in nursing homes. JAm Med Dir Assoc 2011, 12:184-189.
2. Murray L.M., Laditka S.B. Care transitions by older adults from nursing homes to hospitals: Implications for long-term care practice, geriatrics education, and research. JAm Med Dir Assoc 2010, 11:231-238.
3. Grabowski D.C., Stewart K.A., Broderick S.M., Coots L.A. Predictors of nursing home hospitalization. A review of the literature. Med Care Res Rev 2008, 65:3-39.
4. Beringer T.R., Flanagan P. Acute medical bed usage by nursing home residents. Ulster Med J 1999, 68:27-29.
5. Grabowski D.C., O'Malley A.J., Barhydt N.R. The costs and potential savings associated with nursing home hospitalizations. Health Aff (Millwood) 2007, 26:1753-1761.
6. Creditor M.C. Hazards of hospitalization of the elderly. Ann Intern Med 1993, 118:219-223.
7. Ouslander J.G., Lamb G., Perloe M., et al. Potentially avoidable hospitalizations of nursing home residents: Frequency, causes, and costs. JAm Geriatr Soc 2010, 58:627-635.
8. Pedone C., Corsonello A., Carosella L., et al. Comparison of digitalis-related adverse events in hospitalized men and women in Italy: An observational study. Clin Ther 2005, 27:1922-1929.
9. Boockvar K.S., Gruber-Baldini A.L., Burton L., et al. Outcomes of infections in nursing home residents with and without early hospital transfer. JAm Geriatr Soc 2005, 53:590-596.
10. Wong R.Y. Transferring nursing home residents to acute care hospital-to do or not to do, that is the question. JAm Med Dir Assoc 2010, 11:304-305.
11. Dosa D. Should I hospitalize my resident with nursing home-acquired pneumonia?. JAm Med Dir Assoc 2005, 6:327-333.
12. Ouslander J.G., Weinberg A.D., Phillips V. Inappropriate hospitalization of nursing facility residents: A symptom of a sick system of care for frail older people. JAm Geriat Soc 2000, 48:230-231.
13. Loeb M., Carusone S.C., Goeree R., et al. Effect of a clinical pathway to reduce hospitalizations in nursing home residents with pneumonia: A randomized controlled trial. JAMA 2006, 295:2503-2510.
14. Ouslander J.G., Perloe M., Givens J.H., et al. Reducing potentially avoidable hospitalizations of nursing home residents: Results of a pilot quality improvement project. JAm Med Dir Assoc 2009, 10:644-652.
15. Intrator O., Castle N.G., Mor V. Facility characteristics associated with hospitalization of nursing home residents: Results of a national study. Med Care 1999, 37:228-237.
16. Ramroth H., Specht-Leible N., Brenner H. Hospitalisations before and after nursing home admission: A retrospective cohort study from Germany. Age Ageing 2005, 34:291-294.
17. Ramroth H., Specht-Leible N., König H.H., Brenner H. Hospitalizations during the last months of life of nursing home residents: A retrospective cohort study from Germany. BMC Health Serv Res 2006, 6:70. Available at:, Accessed March 1, 2011. http://www.biomedcentral.com/1472%136963/6/70.
18. Lattanzio F., Mussi C., Scafato E., et al. Health care for older people in Italy: TheU.L.I.S.S.E. Project (Un Link Informatico sui Servizi Sanitari Esistenti per l'Anziano; a computerized network on health care services for older people. JNutr Health Aging 2010, 14:238-242.
19. Alzola C, Harrel F. An Introduction to S and The Hmisc and Design Libraries, URL, 2006. Available at: Accessed March 1, 2011. http://CRAN.R-project.org/.
20. Carpenter I., Gambassi G., Topinkova E., et al. Community care in Europe. The Aged in Home Care project (AdHOC). Aging Clin Exp Res 2004, 16:259-269.
21. Morris J.N., Fries B.E., Morris S.A., et al. Scaling ADL's within the MDS. JGerontol 1999, 4:M546-M553.
22. Morris J.N., Fries B.E., Mehr D.R., et al. MDS Cognitive Performance Scale. JGerontol 1994, 49:M174-M182.
23. Hartmaier S.L., Sloane P.D., Guess H.A., et al. Validation of the Minimum Data Set Cognitive Performance Scale: agreement with the Mini-Mental State Examination. JGerontol A Biol Sci Med Sci 1995, 50:M128-M133.
24. Van der Steen J.T., Volicer L., Gerritsen D.L., et al. Defining severe dementia with the Minimum Data Set. Int J Geriatr Psychiatry 2006, 21:1099-1106.
25. Parmelee P.A., Thuras P.D., Katz I.R., et al. Validation of the Cumulative Illness Rating Scale in a geriatric residential population. JAm Geriatr Soc 1995, 43:130-137.
26. Bates D, Sarkar D. lme4: Linear Mixed-Effects Models Using S4 Classes. R package version 0.9975-12, URL, 2007. Available at: Accessed March 1, 2011. http://CRAN.R-project.org/.
27. Tang M., Woo J., Hui E., et al. Utilization of emergency room and hospitalization by Chinese nursing home residents: A cross-sectional study. JAm Med Dir Assoc 2010, 11:325-332.
28. Leendertse A.J., Egberts A.C., Stoker L.J., et al. Frequency of and risk factors for preventable medication-related hospital admissions in the Netherlands. Arch Intern Med 2008, 168:1890-1896.
29. Voisin T., Andrieu S., Cantet C., et al. Predictive factors of hospitalizations in Alzheimer's disease: A two-year prospective study in 686p.tients of the REAL.FR study. JNutr Health Aging 2010, 14:288-291.
30. Nguyen J.K., Fouts M.M., Kotabe S.E., Lo E. Polypharmacy as a risk factor for adverse drug reactions in geriatric nursing home residents. Am J Geriatr Pharmacother 2006, 4:36-41.
31. Hajjar E.R., Cafiero A.C., Hanlon J.T. Polypharmacy in elderly patients. Am J Geriatr Pharmacother 2007, 5:345-351.
32. Kongkaew C., Noyce P.R., Ashcroft D.M. Hospital admissions associated with adverse drug reactions: A systematic review of prospective observational studies. Ann Pharmacother 2008, 42:1017-1025.
33. Ruggiero C., Dell'Aquila G., Gasperini B., et al. ULISSE Study Group. Potentially inappropriate drug prescriptions and risk of hospitalization among older, Italian, nursing home residents: the ULISSE project. Drugs Aging 2010, 27:747-758.
34. Steinman M.A., Hanlon J.T. Managing medications in clinically complex elders: " There's got to be a happy medium." JAMA 2010, 304:1592-1601.
35. Ruths S., Straand J., Nygaard H.A. Multidisciplinary medication review in nursing home residents: what are the most significant drug-related problems? The Bergen District Nursing Home (BEDNURS) study. Qual Saf Health Care 2003, 12:176-180.
36. Bowman C.E., Elford J., Dovey J., et al. Acute hospital admissions from nursing homes: Some may be avoidable. Postgrad Med J 2001, 77:40-42.
37. Dharmarajan T.S., Pankratov A., Morris E., et al. Anemia: Its impact on hospitalizations and length of hospital stay in nursing home and community older adults. JAm Med Dir Assoc 2008, 9:354-359.
38. Tu J.V., Nardi L., Fang J., et al. Canadian Cardiovascular Outcomes Research Team. National trends in rates of death and hospital admissions related to acute myocardial infarction, heart failure and stroke, 1994-2004. CMAJ 2009, 180:E118-E125.
39. Ouslander J.G., Diaz S., Hain D., Tappen R. Frequency and diagnoses associated with 7- and 30-day readmission of skilled nursing facility patients to a nonteaching community hospital. JAm Med Dir Assoc 2011, 12:195-203.
40. Horn S.F., Buerhaus P., Bergstrom N., et al. RN staffing time and outcomes of long-stay nursing home residents: Pressure ulcers and other adverse outcomes are less likely as RNs spend more time on direct patient care. Am J Nurs 2005, 105:58-70.
41. Magaziner J., German P., Zimmerman S.I., et al. The prevalence of dementia in a statewide sample of new nursing home admissions aged 65 and older: Diagnosis by expert panel. Gerontologist 2000, 40:663-672.
42. Burton L.C., German P.S., Gruber-Baldini A.L., et al. Medical care for nursing home residents: Differences by dementia status. Epidemiology of Dementia in Nursing Homes Research Group. JAm Geriatr Soc 2001, 49:142-147.
43. Carter M.W., Porell F.W. Variations in hospitalization rates among nursing home residents: The role of facility and market attributes. Gerontologist 2003, 43:175-191.
44. Pedone C., Ercolani S., Catani M., et al. Elderly patients with cognitive impairment have a high risk for functional decline during hospitalization: the GIFA study. JGerontol 2005, 60:1576-1580.
45. Mecocci P., vonStrauss E., Cherubini A., et al. Cognitive impairment is the major risk factor for development of geriatric syndromes during hospitalization: Results from the GIFA Study. Dement Geriatr Cogn Disord 2005, 20:262-269.
46. Holstein J., Chatellier G., Piette F., Moulias R. Prevalence of associated diseases in different types of dementia among elderly institutionalized patients: Analysis of 3447 records. JAm Geriatr Soc 1994, 42:972-977.
47. Landi F., Gambassi G., Lapane K.L., et al. Comorbidity and drug use in cognitively impaired elderly living in long-term care. Dement Geriatr Cogn Disord 1998, 9:347-356.
48. Zekry D., Herrmann F.R., Grandjean R., et al. Demented versus non-demented very old inpatients: The same comorbidities but poorer functional and nutritional status. Age Ageing 2008, 37:83-89.
49. Zweig S.C., Kruse R.L., Binder E.F., et al. Effect of do-not-resuscitate orders on hospitalization of nursing home residents evaluated for lower respiratory infections. JAm Geriatr Soc 2004, 52:51-58.
50. Gruneir A., Miller S.C., Intrator O., Mor V. Hospitalization of nursing home residents with cognitive impairments: The influence of organizational features and state policies. Gerontologist 2007, 47:447-456.
51. Bostick J.E., Rantz M.J., Flesner M.K., Riggs C.J. Systematic review of studies ofstaffing and quality in nursing homes. JAm Med Dir Assoc 2006, 7:366-376.
52. Kayser-Jones J.S., Wiener C.L., Barbaccia J.C. Factors contributing to the hospitalization of nursing home residents. Gerontologist 1989, 29:502-510.
53. Intrator O., Zinn J., Mor V. Nursing home characteristics and potentially preventable hospitalizations of long-stay residents. JAm Geriatr Soc 2004, 52:1730-1736.
54. Collaborative and supervisory relationships between attending physicians and advanced practice nurses in long-term care facilities. JAm Med Dir Assoc 2011, 12:12-18. American Medical Directors Association ad hoc Work Group on Role of Attending Physician and Advanced Practice Nurse.
55. Philpot C., Tolson D., Morley J.E. Advanced practice nurses and attending physicians: A collaboration to improve quality of care in the nursing home. JAm Med Dir Assoc 2011, 12:161-165.
56. Helton M.R., Cohen L.W., Zimmerman S., van der Steen J.T. The importance of physician presence in nursing homes for residents with dementia and pneumonia. JAm Med Dir Assoc 2011, 12:68-73.
57. Miller S.C., Gozalo P., Mor V. Hospice enrollment and hospitalization of dying nursing home patients. Am J Med 2001, 111:38-44.
58. Gozalo P.L., Miller S.C. Hospice enrollment and evaluation of its causal effect on hospitalization of dying nursing home patients. Health Serv Res 2007, 42:587-610.
59. Ruggiero C., Lattanzio F., Dell'Aquila G., et al. Inappropriate drug prescriptions among older nursing-home residents: The Italian perspective. Drugs Aging 2009, 26:15-30.
60. Zimmerman S., Gruber-Baldini A.L., Hebel J.R., et al. Nursing home facility riskfactors for infection and hospitalization: Importance of registered nurse turnover, administration, and social factors. JAm Geriatr Soc 2002, 50:1987-1995.