Observational studyBMJ open2019
Potentially avoidable hospitalisations of German nursing home patients? A cross-sectional study on utilisation patterns and potential consequences for healthcare.
Observational study in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
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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
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- A systematic review of reasons and risks for acute service use by older adult residents of long-term care.Journal of clinical nursing · 2025Pooled it
- Implementation of a complex intervention to improve interprofessional collaboration in long-term care: results of the mixed-methods process evaluation within the interprof ACT trial.BMC health services research · 2026Trial
- Effects of an interprofessional care concept in nursing homes evaluated in the SaarPHIR project: A cluster-randomized controlled trial.PloS one · 2025Trial
- Cluster randomised trial of a complex interprofessional intervention (interprof ACT) to reduce hospital admission of nursing home residents.Age and ageing · 2023Trial
- [Health status of older people in long-term inpatient care-a narrative review].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2026Review
- General-practitioner-centered health care: current results from the implementation of the German model.Scientific reports · 2026Article
- Article
- Biological sex-dependent differences in acute and post-acute stroke care-a population-based case-control study.European stroke journal · 2026Article
- Impact of regular televisits on unplanned hospital admissions of nursing home residents in rural Germany: a pre-post intervention study.BMC geriatrics · 2025Article
- Hospitalizations, emergency medical care utilization, and contacts with the regional on-call medical services among nursing home residents in Germany: a cross-sectional study in 44 nursing homes.BMC health services research · 2025Article
- How the Content of Interprofessional Safety Management Education Can Be Structured Through the Perception of Nursing Home Practitioners: A Mixed Methods Design.Nursing open · 2024Article
- The Use of Medical Services for Low-Acuity Emergency Cases in Germany: Protocol for a Multicenter Observational Pilot Study.JMIR research protocols · 2024Article
- Cost-benefit analysis of the CoCare intervention to improve medical care in long-term care nursing homes: an analysis based on claims data.The European journal of health economics : HEPAC : health economics in prevention and care · 2023Article
- Article
- [Nursing home-sensitive conditions and approaches to reduce hospitalization of nursing home residents].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2023Article
- [Structuring emergency management in nursing homes: Results of interprofessional focus group interviews].Zeitschrift fur Gerontologie und Geriatrie · 2022Article
- Article
- The Use of Telemedicine in Nursing Homes: A Mixed-Method Study to Identify Critical Factors When Connecting with a General Hospital.International journal of environmental research and public health · 2021Article
- Socioeconomic position and risk of unplanned hospitalization among nursing home residents: a nationwide cohort study.European journal of public health · 2021Article
- Predictive Modeling of 30-Day Emergency Hospital Transport of German Patients Using a Personal Emergency Response: Retrospective Study and Comparison with the United States.JMIR medical informatics · 2021Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesDemand for nursing home (NH) care is soaring due to gains in life expectancy and people living longer with chronic illness and disability. This is dovetailing with workforce shortages across the healthcare profession. Access to timely and appropriate medical care for NH residents is becoming increasingly challenging and can result in potentially avoidable hospitalisations (PAHs). In light of these factors, we analysed PAHs comparing NH patients with non-NH patients.
designCross-sectional study with claims data from 2015 supplied by a large German health insurance company within the federal state of Baden-Wuerttemberg.
settingOne-year observation of hospitalisation patterns for NH and non-NH patients.
participants3 872 245 of the 10.5million inhabitants of Baden-Wuerttemberg were covered.
methodsPatient data about hospitalisation date, sex, age, nationality, level of care and diagnoses were available. PAHs were defined based on international classification of diseases (ICD-10) diagnoses belonging to ambulatory care sensitive conditions (ACSCs). Adjusted ORs for PAHs for NH patients in comparison with non-NH patients were calculated with multivariable regression models.
resultsOf the 933 242 hospitalisations in 2015, there were 23 982 for 13 478 NH patients and 909 260 for 560 998 non-NH patients. Mean age of hospitalised NH patients and level of care were significantly higher than those of non-NH patients. 6449 PAHs (29.6%) for NH patients and 136 543 PAHs (15.02%) for non-NH patients were identified. The adjusted OR for PAHs was significantly heightened for NH patients in comparison with non-NH patients (OR: 1.22, CI (1.18 to 1.26), p<0.0001). Moreover, we could observe that more than 90% of PAHs with ACSCs were unplanned hospitalisations (UHs).
conclusionsLarge numbers of PAHs for NH patients calls for improved coordination of medical care, especially general practitioner service provision. Introduction of targeted training programmes for physicians and NH staff on health problem management for NH patients could perhaps contribute to reduction of PAHs, predominantly UHs.
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