ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2012
Hospital admissions from nursing homes: a qualitative study of GP decision making.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 3 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- How do primary care clinicians approach hospital admission decisions for people in the final year of life? A systematic review and narrative synthesis.Palliative medicine · 2024Pooled it
- Experiences and involvement of family members in transfer decisions from nursing home to hospital: a systematic review of qualitative research.BMC geriatrics · 2019Pooled it
- Concordance of effects of medical interventions on hospital admission and readmission rates with effects on mortality.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2013Pooled it
- Effects of an interprofessional care concept in nursing homes evaluated in the SaarPHIR project: A cluster-randomized controlled trial.PloS one · 2025Trial
- Trial
- Factors associated with the goal of treatment in the last week of life in old compared to very old patients: a population-based death certificate survey.BMC geriatrics · 2014Trial
- Construct validity of measures of care home resident quality of life: cross-sectional analysis using data from a pilot minimum data set in England.Health and quality of life outcomes · 2025Article
- Barriers and facilitators in implementing advance care planning for frail older patients acutely admitted to geriatric hospital units: a nested qualitative study.Frontiers in health services · 2025Article
- Trends and characteristics of hospitalisation and mortality among centenarians in old-age homes and communities: a territory-wide study in Hong Kong, 2012-2021.BMJ public health · 2025Article
- Implementation of a program for treatment of acute infections in nursing homes without hospital transfer.Frontiers in medicine · 2024Article
- Do mobile hospital teams in residential aged care facilities increase health care efficiency: an evaluation of French residential care policy.The European journal of health economics : HEPAC : health economics in prevention and care · 2023Article
- Nursing Home-Sensitive Hospitalizations and the Relevance of Telemedicine: A Scoping Review.International journal of environmental research and public health · 2022Article
- Using advance and emergency care plans during transfer decisions: A grounded theory interview study with care home staff.Palliative medicine · 2022Article
- Unplanned hospital transfers from nursing homes: who is involved in the transfer decision? Results from the HOMERN study.Aging clinical and experimental research · 2021Article
- Physicians' decreased tendency to choose palliative care for patients with advanced dementia between 1999 and 2015.BMC palliative care · 2021Article
- What are the risk factors for avoidable transitions in the last year of life? A qualitative exploration of professionals' perspectives for improving care in Germany.BMC health services research · 2021Article
- Observational
- Association between palliative care and healthcare outcomes among adults with terminal non-cancer illness: population based matched cohort study.BMJ (Clinical research ed.) · 2020Article
- Perspectives of general practitioners and nursing staff on acute hospital transfers of nursing home residents in Germany: results of two cross-sectional studies.BMC family practice · 2020Article
- Challenges and strategies for general practitioners diagnosing serious infections in older adults: a UK qualitative interview study.BMC family practice · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDecisions regarding the hospitalisation of nursing home residents may present a difficult dilemma for GPs. There are pressures to admit very frail patients with exacerbations of illness even though such frailty may limit the possible health gains. As 'gatekeepers' to NHS, GPs are expected to make best use of resources and may be criticised for 'inappropriate' admissions. Little is understood about the influences on GPs as they make such decisions.
aimTo explore GPs views on factors influencing decisions on admitting frail nursing home residents to hospital. DESIGN AND
settingA purposive sample of 21 GPs from two counties in the South of England.
methodData from semi-structured, one-to-one interviews with GPs were analysed using thematic analysis following principles of the constant comparative method.
resultsThis study suggests that while clinical assessment, perceived benefits and risks of admission, and patients' and relatives' preferences are key factors in determining admissions, other important factors influencing decision making include medico-legal concerns, communications, capability of nursing homes and GP workload. These factors were also perceived by GPs as influencing the feasibility of keeping patients in the nursing home when this was clinically appropriate. Key areas suggested by GPs to improve practice were improving communication (particularly informational continuity), training and support for nursing staff, and peer support for GPs. Local initiatives to address these issues were very variable.
conclusionDeveloping a systematic palliative care approach to address poor documentation and communication, the capability of nursing homes, and medico-legal concerns has the potential to improve decision-making regarding hospital admissions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.