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The journal of nutrition, health & aging

, Volume 18, Issue 7, pp 705–709 | Cite as

Multimorbidity type, hospitalizations and emergency department visits among nursing home residents: A preliminary study

  • Philipe de Souto BarretoEmail author
  • M. Lapeyre-Mestre
  • B. Vellas
  • Y. Rolland
Article

Abstract

Background

The burden of multimorbidity in institutionalized elderly is poorly investigated. We examined the associations of the type of multimorbidity (i.e., physical, mental or both) with the number of hospitalizations and emergency department (ED) visits in nursing home (NH) residents.

Methods

This is a cross-sectional study among NH residents. Information on residents’ health, number of hospitalizations in the last 12 months and hospital department of admission (having been seen in ED vs. non) was recorded by NH staff of 175 French NHs (data was collected in 2011). Participants were screened for the presence of several mental (e.g., dementia) and physical conditions (e.g., diabetes).

Results

Data on hospitalization was available for 6076 NH residents. Compared to having no diseases, the concomitant presence of ≥ 2 physical conditions was the multimorbidity type more strongly associated with both the number of hospitalizations (incidence rate ratio (IRR) =1.93; 95% confidence interval (CI) =1.57 − 2.37) and ED visits (odds ratio (OR)= 1.79; 95% CI=1.24 − 2.58). The presence of a mental condition appeared to moderate the associations between physical conditions and hospitalizations, since the estimate effects were lower among people who had both physical and mental conditions, compared to those with only physical conditions. For example, compared to people with ≥ 2 physical conditions, those with multiple physical and mental conditions had lower IRR (IRR = 0.84; 95% CI=0.75 − 0.95) for the number of hospitalizations.

Conclusions

Mental diseases in very old and multimorbid NH residents probably moderate the associations between physical diseases and hospitalizations. To what extent this represents either a mirror of better clinical practice in NHs or the under-recognition from the NH staff of symptoms leading to justifiable hospitalizations remains unclear.

Key words

Older adults multimorbidity nursing home hospitalization emergency department 

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Copyright information

© Serdi and Springer-Verlag France 2014

Authors and Affiliations

  • Philipe de Souto Barreto
    • 1
    • 2
    Email author
  • M. Lapeyre-Mestre
    • 3
    • 4
  • B. Vellas
    • 1
    • 3
  • Y. Rolland
    • 1
    • 3
  1. 1.Gérontopôle de Toulouse, Institut du VieillissementCentre Hospitalo-Universitaire de Toulouse (CHU Toulouse)ToulouseFrance
  2. 2.UMR7268 ADESAix-Marseille Univ.MarseilleFrance
  3. 3.UMR INSERM 1027University of Toulouse IIIToulouseFrance
  4. 4.Service de Pharmacologie CliniqueCHU de ToulouseToulouseFrance

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