ArticleBMJ public health2026
Trends in end-of-life hospitalisations of nursing home residents: a systematic review.
Article in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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3 authors.
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Abstract
Objectives: Worldwide, nursing homes are increasingly becoming a place for the last phase of life, with residents often being hospitalised near death. This might have changed by implementing end-of-life care structures more widely over years. Therefore, we aimed to systematically investigate trends in end-of-life hospitalisations among nursing home residents. Design: Systematic review. Data sources: MEDLINE (via PubMed), CINAHL and EMBASE were searched from inception to 24 April 2025, supplemented by citation searching. Eligibility criteria: Observational studies with ≥100 deceased residents reporting proportions of in-hospital deaths or hospitalisations in the last month of life for at least two observations being at least 3 years apart were included. Data extraction and synthesis: Studies were summarised descriptively. Percentage point changes between the initial and last observations of end-of-life hospitalisations were calculated. Study quality was assessed using the Joanna Briggs Institute's tool. Results: We screened 4122 records for eligibility and included 12 studies published in 13 articles covering data from Belgium, Germany, Japan and the USA. Reported number of included residents ranged from 1647 to 2 954 276 and most studies assessed only one period in the month before death, mostly in-hospital deaths. 10 studies assessed trends in in-hospital deaths; those with higher initial proportions (from 30.3% to 79.2%, n=8) indicated a decrease (-2.0 to -23.5 percentage points). Trends on hospitalisations in the last month of life (n=5) were heterogeneous. Only three studies stratified findings by age, sex or presence of dementia. End-of-life hospitalisations for all age groups and both sexes have decreased over time, but this trend is inconclusive for residents with and without dementia. Conclusions: Trends in end-of-life hospitalisations vary between countries. As more policies have been implemented worldwide in recent years aiming to improve end-of-life care in nursing homes, longitudinal studies investigating trends from other countries are needed. PROSPERO registration number: CRD420251038131.
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