Short summary

With this study, we want to improve the course for nursing home residents in the event of acute illness, by reducing avoidable admissions and by improving the cooperation between hospital, citizen/relatives and municipality.With this study, we want to improve the course for nursing home residents in the event of acute illness, by reducing avoidable admissions and by improving the cooperation between hospital, citizen/relatives and municipality.

Rationale

This study is part of a larger project named "På FORKANT - at the Fore Front of Older Peoples Care", a collaboration between the municipalities of Haderslev, Aabenraa, Tønder and Sønderborg, general practitioners in these municipalities, the Hospital of Southern Jutland and the University of Southern Denmark. "At the Fore Front of Older Peoples Care" is working to improve conditions for older citizens before, during and after hospital admission and to improve the cooperation between sectors in the health care system.
In this particular study, we focus only on nursing home residents. Nursing home residents are often frail citizens with high age, multi morbidity, cognitive and functional impairment. Danish nursing home residents have a higher frequency of hospitalization compared to community dwelling elderly. Hospitalization of frail elderly leads to a high risk of complications such as hospital acquired infections, delirium and falls. It is unknown whether acute hospitalization of nursing home residents actually has a beneficial effect on morbidity and mortality. 
A rapport from the Danish Ministry of Health from 2016 states that 126 of 1000 acute admissions of nursing home resident could have been avoided through early recognition of symptoms of disease. In comparison, the number of potentially avoidable admissions in community dwelling elderly of the same age group is 47 in 1000. 
When moving into a nursing home facility Danish nursing home residents have an average life expectancy of 2 years and 8 month, and 1/3 die in less than 6 months. In this final stage of life an acute hospital admission is not always the most gentle or beneficial treatment for the citizen. 
We need to know how to distinguish between appropriate and inappropriate acute admissions among nursing home residents. We need to prevent or reduce inappropriate acute admissions and re-admissions. We need to strengthen the collaboration between different actors of the health care system: Citizen, relatives, nursing home staff, general practitioners and hospitals.

Description of the cohort

Nursing home residents in the 4 municipalities of Southern Jutland: Haderslev, Aabenraa, Tønder and Sønderborg. 

Collaborating researchers and departments

Department of Regional Health Research - the Focused Research Unit in Emergency Medicine, University of Southern Denmark and Department of Emergency, Hospital of Southern Jutland

• PhD student Gitte Schultz Lindskov Kristensen

• Clinical professor, Head of research unit, Christian Backer Mogensen, PhD, MHM

Department of Clinical Research and Department of Public Health, University of Southern Denmark

• Clinical Professor Karen Andersen-Ranberg, MD, PhD

Research Unit for General Practice, Department of public Health, University of Southern Denmark

• Professor Jens Søndergaard, PhD