Abstract : OBJECTIVES This study determined factors associated with increased use of emergency room (ER) and h
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Abstract : OBJECTIVES This study determined factors associated with increased use of emergency room (ER) and hospitalization of Chinese nursing home residents.|DESIGN A cross-sectional study.|SETTING The setting was 14 nursing homes in Hong Kong.|PARTICIPANTS Participants were 1820 Chinese nursing home residents.|MEASUREMENTS Data on facility factors and resident factors were collected. Resident factors were mainly collected by the Minimum Data Set-Resident Assessment Instrument 2.0 (MDS-RAI 2.0).|RESULTS Residing in a for-profit home (OR=6.51) having less than one third of time spent in activities (OR=1.84) having had recent fall (OR=3.81) having renal failure (OR=3.17) having had recent initiation of new medications (OR=1.42) and having had recent physician visit (OR=1.67) were factors associated with increased use of ER. Male gender (OR=1.49) having a body mass index (BMI) less than 18.5 kg/m(2) (OR=1.51) being more functionally dependent (OR=1.18 per 1-point increment in the ADL Hierarchy Scale) having higher burden of illness (OR=1.29 per 1-point increment in the CHESS score) having a feeding tube (OR=3.07) having an indwelling urinary catheter (OR=2.75) having had recent fall (OR=1.94) having respiratory tract infection (OR=2.05) having Parkinsons disease (OR=1.55) having anemia (OR=1.70) having had recent initiation of new medications (OR=2.08) and having had recent physician visit (OR=1.83) were factors associated with increased risk of hospitalization.|CONCLUSIONS: Although some of the associated factors reflect frailty characteristics of residents, differences in association between for-profit and not-for-profit institutions provide evidence of overreliance on the ER, perhaps as a result of inadequate primary care support.|
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