Predictors of hospitalization in Italian nursing home residents: the U.L.I.S.S.E. project

Objective: To examine resident and facility characteristics associated with hospitalization in a cohort of Italian older nursing home residents. Design: A longitudinal observational study. Setting: The nursing homes participating in the U.L.I.S.S.E. study, a project evaluating the quality of care for older persons in Italy. Setting Participants Nursing home residents in 31 Italian nursing homes. Measurement: Each resident underwent a comprehensive geriatric assessment at baseline, and after 6 months and 1 year by means of the RAI MDS 2.0. Facility characteristics were collected using an ad hoc designed questionnaire. Hospitalizations were self-reported by facilities. Results: A total of 170 (11.6%) of 1466 nursing home residents were admitted to the hospital at least once during the study period. Female gender and higher physician, nurse, and nursing assistant hours per resident were predictive of a lower probability to be admitted to the hospital, whereas a diagnosis of arrhythmia, a previous urinary tract infection, and polypharmacy were associated with a higher probability of being hospitalized. Conclusion: These findings suggest that a reduction of hospitalization of nursing home residents could be achieved by providing an adequate amount of care and optimizing the management of chronic diseases and polypharmacy. This hypothesis should be tested in future clinical trials.