What is inappropriate hospital use for elderly people near the end of life? A systematic review

European Journal of Internal Medicine
M Cardona-MorrellKen Hillman

Abstract

Older people with advance chronic illness use hospital services repeatedly near the end of life. Some of these hospitalizations are considered inappropriate. To investigate extent and causes of inappropriate hospital admission among older patients near the end of life. English language publications in Medline, EMBASE, PubMed, Cochrane library, and the grey literature (January 1995-December 2016) covering community and nursing home residents aged ≥60years admitted to hospital. measurements of inappropriateness. A 17-item quality score was estimated independently by two authors. The definition of 'Inappropriate admissions' near the end of life incorporated system factors, social and family factors. The prevalence of inappropriate admissions ranged widely depending largely on non-clinical reasons: poor availability of alternative sites of care or failure of preventive actions by other healthcare providers (1.7-67.0%); family requests (up to 10.5%); or too late an admission to be of benefit (1.7-35.0%). The widespread use of subjective parameters not routinely collected in practice, and the inclusion of non-clinical factors precluded the true estimation of clinical inappropriateness. Clinical inappropriateness and system factors th...Continue Reading

Citations

Dec 14, 2018·Health Services Management Research : an Official Journal of the Association of University Programs in Health Administration·Rocco Palumbo, Rosalba Manna
Aug 2, 2019·Palliative Medicine·Katharina AllersRieke Schnakenberg
May 30, 2020·International Journal of Environmental Research and Public Health·Alexandra PulstGuido Schmiemann
Feb 23, 2019·Journal of Palliative Medicine·Aluem TarkPatricia W Stone
Mar 9, 2019·The Canadian Journal of Nursing Research = Revue Canadienne De Recherche En Sciences Infirmières·Donna M WilsonStephen Birch
Sep 6, 2020·Journal of Advanced Nursing·Amy WallerRobert Sanson-Fisher
Dec 2, 2020·Aging Clinical and Experimental Research·Alexandra PulstGuido Schmiemann

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