Home > Research > Publications & Outputs > Hospitalisation in the last month of life and i...

Links

Text available via DOI:

View graph of relations

Hospitalisation in the last month of life and in-hospital death of nursing home residents: A cross-sectional analysis of six European countries

Research output: Contribution to journalJournal articlepeer-review

Published

Standard

Hospitalisation in the last month of life and in-hospital death of nursing home residents : A cross-sectional analysis of six European countries. / Honinx, E.; Piers, R.D.; Onwuteaka-Philipsen, B.D.; Payne, S.; Szczerbińska, K.; Gambassi, G.; Kylänen, M.; Deliens, L.; Van Den Block, L.; Smets, T.

In: BMJ Open, Vol. 11, No. 8, e047086, 31.08.2021.

Research output: Contribution to journalJournal articlepeer-review

Harvard

Honinx, E, Piers, RD, Onwuteaka-Philipsen, BD, Payne, S, Szczerbińska, K, Gambassi, G, Kylänen, M, Deliens, L, Van Den Block, L & Smets, T 2021, 'Hospitalisation in the last month of life and in-hospital death of nursing home residents: A cross-sectional analysis of six European countries', BMJ Open, vol. 11, no. 8, e047086. https://doi.org/10.1136/bmjopen-2020-047086

APA

Honinx, E., Piers, R. D., Onwuteaka-Philipsen, B. D., Payne, S., Szczerbińska, K., Gambassi, G., Kylänen, M., Deliens, L., Van Den Block, L., & Smets, T. (2021). Hospitalisation in the last month of life and in-hospital death of nursing home residents: A cross-sectional analysis of six European countries. BMJ Open, 11(8), [e047086]. https://doi.org/10.1136/bmjopen-2020-047086

Vancouver

Author

Honinx, E. ; Piers, R.D. ; Onwuteaka-Philipsen, B.D. ; Payne, S. ; Szczerbińska, K. ; Gambassi, G. ; Kylänen, M. ; Deliens, L. ; Van Den Block, L. ; Smets, T. / Hospitalisation in the last month of life and in-hospital death of nursing home residents : A cross-sectional analysis of six European countries. In: BMJ Open. 2021 ; Vol. 11, No. 8.

Bibtex

@article{712bea133ff74c9188296350ff1b0333,
title = "Hospitalisation in the last month of life and in-hospital death of nursing home residents: A cross-sectional analysis of six European countries",
abstract = "Objectives To examine the rate and characteristics of hospitalisation in the last month of life and place of death among nursing home residents and to identify related care processes, facility factors and residents{\textquoteright} characteristics. Setting A cross-sectional study (2015) of deceased residents in 322 nursing homes in six European countries. Participants The nursing home manager (N=1634), physician (N=1132) and primary nurse (N=1384) completed questionnaires. Outcome measures Hospitalisation and place of death were analysed using generalised linear and logistic mixed models. Multivariate analyses were conducted to determine associated factors. Results Twelve to 26% of residents were hospitalised in the last month of life, up to 19% died in-hospital (p<0.001). Belgian residents were more likely to be hospitalised than those in Italy, the Netherlands and Poland. For those dying in-hospital, the main reason for admission was acute change in health status. Residents with a better functional status were more likely to be hospitalised or to die in-hospital. The likelihood of hospitalisation and in-hospital death increased if no conversation on preferred care with a relative was held. Not having an advance directive regarding hospitalisations increased the likelihood of hospitalisation. Conclusions Although participating countries vary in hospitalisation and in-hospital death rates, between 12% (Italy) and 26% (Belgium) of nursing home residents were hospitalised in the last month of life. Close monitoring of acute changes in health status and adequate equipment seem critical to avoiding unnecessary hospitalisations. Strategies to increase discussion of preferences need to be developed. Our findings can be used by policy-makers at governmental and nursing home level.",
keywords = "adult palliative care, geriatric medicine, public health, adult, article, Belgian, Belgium, controlled study, conversation, cross-sectional study, female, functional status, geriatrics, hospitalization, human, in-hospital mortality, Italy, living will, major clinical study, male, Netherlands, nursing home patient, outcome assessment, palliative therapy, Poland",
author = "E. Honinx and R.D. Piers and B.D. Onwuteaka-Philipsen and S. Payne and K. Szczerbi{\'n}ska and G. Gambassi and M. Kyl{\"a}nen and L. Deliens and {Van Den Block}, L. and T. Smets",
year = "2021",
month = aug,
day = "31",
doi = "10.1136/bmjopen-2020-047086",
language = "English",
volume = "11",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "8",

}

RIS

TY - JOUR

T1 - Hospitalisation in the last month of life and in-hospital death of nursing home residents

T2 - A cross-sectional analysis of six European countries

AU - Honinx, E.

AU - Piers, R.D.

AU - Onwuteaka-Philipsen, B.D.

AU - Payne, S.

AU - Szczerbińska, K.

AU - Gambassi, G.

AU - Kylänen, M.

AU - Deliens, L.

AU - Van Den Block, L.

AU - Smets, T.

PY - 2021/8/31

Y1 - 2021/8/31

N2 - Objectives To examine the rate and characteristics of hospitalisation in the last month of life and place of death among nursing home residents and to identify related care processes, facility factors and residents’ characteristics. Setting A cross-sectional study (2015) of deceased residents in 322 nursing homes in six European countries. Participants The nursing home manager (N=1634), physician (N=1132) and primary nurse (N=1384) completed questionnaires. Outcome measures Hospitalisation and place of death were analysed using generalised linear and logistic mixed models. Multivariate analyses were conducted to determine associated factors. Results Twelve to 26% of residents were hospitalised in the last month of life, up to 19% died in-hospital (p<0.001). Belgian residents were more likely to be hospitalised than those in Italy, the Netherlands and Poland. For those dying in-hospital, the main reason for admission was acute change in health status. Residents with a better functional status were more likely to be hospitalised or to die in-hospital. The likelihood of hospitalisation and in-hospital death increased if no conversation on preferred care with a relative was held. Not having an advance directive regarding hospitalisations increased the likelihood of hospitalisation. Conclusions Although participating countries vary in hospitalisation and in-hospital death rates, between 12% (Italy) and 26% (Belgium) of nursing home residents were hospitalised in the last month of life. Close monitoring of acute changes in health status and adequate equipment seem critical to avoiding unnecessary hospitalisations. Strategies to increase discussion of preferences need to be developed. Our findings can be used by policy-makers at governmental and nursing home level.

AB - Objectives To examine the rate and characteristics of hospitalisation in the last month of life and place of death among nursing home residents and to identify related care processes, facility factors and residents’ characteristics. Setting A cross-sectional study (2015) of deceased residents in 322 nursing homes in six European countries. Participants The nursing home manager (N=1634), physician (N=1132) and primary nurse (N=1384) completed questionnaires. Outcome measures Hospitalisation and place of death were analysed using generalised linear and logistic mixed models. Multivariate analyses were conducted to determine associated factors. Results Twelve to 26% of residents were hospitalised in the last month of life, up to 19% died in-hospital (p<0.001). Belgian residents were more likely to be hospitalised than those in Italy, the Netherlands and Poland. For those dying in-hospital, the main reason for admission was acute change in health status. Residents with a better functional status were more likely to be hospitalised or to die in-hospital. The likelihood of hospitalisation and in-hospital death increased if no conversation on preferred care with a relative was held. Not having an advance directive regarding hospitalisations increased the likelihood of hospitalisation. Conclusions Although participating countries vary in hospitalisation and in-hospital death rates, between 12% (Italy) and 26% (Belgium) of nursing home residents were hospitalised in the last month of life. Close monitoring of acute changes in health status and adequate equipment seem critical to avoiding unnecessary hospitalisations. Strategies to increase discussion of preferences need to be developed. Our findings can be used by policy-makers at governmental and nursing home level.

KW - adult palliative care

KW - geriatric medicine

KW - public health

KW - adult

KW - article

KW - Belgian

KW - Belgium

KW - controlled study

KW - conversation

KW - cross-sectional study

KW - female

KW - functional status

KW - geriatrics

KW - hospitalization

KW - human

KW - in-hospital mortality

KW - Italy

KW - living will

KW - major clinical study

KW - male

KW - Netherlands

KW - nursing home patient

KW - outcome assessment

KW - palliative therapy

KW - Poland

U2 - 10.1136/bmjopen-2020-047086

DO - 10.1136/bmjopen-2020-047086

M3 - Journal article

VL - 11

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 8

M1 - e047086

ER -