ArticleBMJ open2021
Predictors of hospitalisations and emergency department presentations shortly after entering a residential aged care facility in Australia: a retrospective cohort study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- 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
- Variations in older people's emergency care use by social care setting: a systematic review of international evidence.British medical bulletin · 2024Pooled it
- Impact of relational continuity of primary care in aged care: a systematic review.BMC geriatrics · 2022Pooled it
- Article
- Development of machine learning models to predict risk of hospitalisation and 90-day readmission among patients with cardiovascular risk factors using community health survey data.BMJ health & care informatics · 2025Article
- Factors Associated With Hospitalization for Hypoglycemia and Hyperglycemia Among Older People in Long-Term Care Facilities.Journal of the American Geriatrics Society · 2025Article
- The risk of delirium or dementia-related hospitalization among individuals living with dementia after long-term care entry: A population-based risk prediction model.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Enhancing Person-Centred Care in the Final Years of Life: Insights From Emergency Department Visits and Hospitalisations in Victorian Residential Aged Care (2015/16 to 2022/23).Emergency medicine Australasia : EMA · 2025Article
- Article
- Utilisation of mobile X-ray services by residents of long-term care facilities.Internal medicine journal · 2025Article
- Medication management in long-term care: using evidence generated from real-world data to effect policy change in the Australian setting.American journal of epidemiology · 2024Article
- Predictors of mortality shortly after entering a long-term care facility.Age and ageing · 2024Article
- Potentially inappropriate medication use as predictors of hospitalization for residents in nursing home.BMC geriatrics · 2023Article
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo: (1) examine the 90-day incidence of unplanned hospitalisation and emergency department (ED) presentations after residential aged care facility (RACF) entry, (2) examine individual-related, facility-related, medication-related, system-related and healthcare-related predictors of these outcomes and (3) create individual risk profiles.
designRetrospective cohort study using the Registry of Senior Australians. Fine-Gray models estimated subdistribution HRs and 95% CIs. Harrell's C-index assessed risk models' predictive ability. SETTING AND
participantsIndividuals aged ≥65 years old entering a RACF as permanent residents in three Australian states between 1 January 2013 and 31 December 2016 (N=116 192 individuals in 1967 RACFs). PREDICTORS EXAMINED: Individual-related, facility-related, medication-related, system and healthcare-related predictors ascertained at assessments or within 90 days, 6 months or 1 year prior to RACF entry. OUTCOME MEASURES: 90-day unplanned hospitalisation and ED presentation post-RACF entry.
resultsThe cohort median age was 85 years old (IQR 80-89), 62% (N=71 861) were women, and 50.5% (N=58 714) had dementia. The 90-day incidence of unplanned hospitalisations was 18.0% (N=20 919) and 22.6% (N=26 242) had ED presentations. There were 34 predictors of unplanned hospitalisations and 34 predictors of ED presentations identified, 27 common to both outcomes and 7 were unique to each. The hospitalisation and ED presentation models out-of-sample Harrell's C-index was 0.664 (95% CI 0.657 to 0.672) and 0.655 (95% CI 0.648 to 0.662), respectively. Some common predictors of high risk of unplanned hospitalisation and ED presentations included: being a man, age, delirium history, higher activity of daily living, behavioural and complex care needs, as well as history, number and recency of healthcare use (including hospital, general practitioners attendances), experience of a high sedative load and several medications.
conclusionsWithin 90 days of RACF entry, 18.0% of individuals had unplanned hospitalisations and 22.6% had ED presentations. Several predictors, including modifiable factors, were identified at the time of care entry. This is an actionable period for targeting individuals at risk of hospitalisations.
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