Abstract
ObjectivesReducing nursing home hospitalizations for ambulatory care sensitive conditions (ACSC) has been identified as an opportunity to improve patient well-being and reduce costs. The aim of this study was to identify number of hospitalizations for ACSCs for nursing home residents in a Swiss national sample, examine demographic characteristics of nursing home hospitalizations due to ACSCs, and calculate hospital expenses from these hospitalizations.MethodsUsing merged hospital administrative data with payment data based on diagnosis-related groups (DRGs) for the year 2013, we descriptively examined nursing home residents who were 65 years of age or older and were admitted to an acute care hospital.ResultsApproximately 42% of all nursing home admissions were due to ACSCs. Payments to Swiss hospitals for ACSCs can be estimated at between 89 and 105 million Swiss francs in 2013.ConclusionsA sizable share of hospitalizations for nursing home residents is for ACSCs, and the associated costs are substantial. Programs and policies designed to reduce these potentially avoidable hospitalizations from the nursing home setting could lead to an increased patient well-being and lower costs.
Highlights
Reducing preventable hospitalizations of nursing home residents is important to the health and well-being of nursing home residents (Ouslander and Maslow 2012; Walsh et al 2012)
Using merged hospital administrative data with payment data based on diagnosis-related groups (DRGs) for the year 2013, we descriptively examined nursing home residents who were 65 years of age or older and were admitted to an acute care hospital
Identifying ambulatory care sensitive conditions (ACSC) can serve as an approximation of potentially preventable hospitalizations, the effective management of these conditions outside the hospital setting depends on a variety of factors
Summary
Reducing preventable hospitalizations of nursing home residents is important to the health and well-being of nursing home residents (Ouslander and Maslow 2012; Walsh et al 2012). Several estimates show that in the USA and Canada, between 20 and 60% of hospitalizations from nursing homes are considered preventable (Mcandrew et al 2016; Ouslander et al 2010; Walker et al 2009; Walsh et al 2012). These hospitalizations are a major burden to residents and a substantial financial burden to the health-care delivery system, with the costs of a hospitalization averaging between $8000 and $20,000 in the USA (Axon et al 2015; Grabowski et al 2007; Mcandrew et al 2016; Walsh et al 2010; Xing et al 2013). Reimbursement policies might favor hospitalizations (Ashton 2014)
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