Long-term care residents with a history of falls, cognitive decline and specific demographic characteristics were at greater likelihood for fall-related hospital transfers than those who did not have the same risk factors, according to a new study.
Falls are a leading cause of transfer of long-term care residents to the emergency department and hospital, researchers from Indiana University who conducted the study noted. In their study, researchers attempted to identify the characteristics of long-term care residents who were transferred to hospitals due to falls compared to other non-fall related factors.
The study, which appeared in the Annals of Long-Term Care, is part of the Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC), a Centers for Medicare & Medicaid Services demonstration project designed to reduce potentially avoidable hospital transfers among LTC residents. For the study, researchers investigated a total of 1,644 transfers of 877 residents from 17 nursing facilities to hospitals over a 27-month period.
Researchers found that residents who had a higher risk of hospital transfers due to falls were white, female, 80 years or older, experienced cognitive impairment and had frequent or occasional episodes of incontinence.
“The key risk factors identified in this study — aged 80 years or older, female sex, white race, history of falls, and cognitive impairment — were found to be most strongly associated with hospital transfers due to falls compared with transfers due to other reasons, and they are consistent with the risk factors identified in established fall prevention programs,” the authors wrote.
The study also found that the majority of those residents who were transferred only needed care in the ED and did not require hospitalization. Given that many of the residents who were transferred only required ED visits and not hospitalization, researchers say their findings may suggest the potential to identify a larger group of residents who can be safely assessed within the facilities and avoiding transfers altogether in those cases.
“Overall, this study presents a silver lining to nursing facility teams, who can incorporate these findings into developing care plans to identify the group of residents with high risk for fall-related transfers and address this risk with a multifaceted solution,” the authors wrote. “These variables may also help in discussions with family and caregivers about hospital transfer risks.”
