Residents with Alzheimer's disease in long-term care facilities in Hong Kong: patterns of hospitalization and emergency room use

• Published in: Aging & mental health Vol. 17; no. 8; pp. 959 - 965
• Main Authors: Leung, Angela Y.M., Kwan, C.W., Chi, Iris
• Format: Journal Article
• Language: English
• Published: England Routledge 01.11.2013
• Subjects: Activities of Daily Living - psychology; Aged; Aged, 80 and over; Alzheimer Disease - drug therapy; Alzheimer Disease - nursing; Alzheimer Disease - physiopathology; Alzheimer's disease; Chinese people; Diseases; Drugs; emergency room; Emergency Service, Hospital - statistics & numerical data; Emergency Service, Hospital - utilization; Female; Health care; Hong Kong; Hospitalization; Hospitalization - statistics & numerical data; Humans; Illness; Long term hospitals; Long-Term Care - statistics & numerical data; long-term care facilities; Longitudinal Studies; Male; Medical care; Medical treatment; Pharmaceuticals; Polypharmacy; Prescriptions; Process Assessment (Health Care); Psychotropic drugs; Surveys and Questionnaires; Time Factors; Hong Kong
• ISSN: 1360-7863; 1364-6915
• DOI: 10.1080/13607863.2013.768211

Objectives: This study examined the frequency and predictors of hospitalization and emergency room (ER) use among residents with Alzheimer's disease at admission and after 1 year in a long-term care facility. Method: This secondary analysis used data collected with the Chinese version of the Residential Assessment Instrument Minimum Data Set 2.0 during the Hong Kong Longitudinal Study on Long-Term Care Facility Residents. Results: A sample of 169 residents with Alzheimer's disease who were newly admitted between 2005 and 2010 was included in the analysis. Mixed-effects modeling was adopted to assess the associations between risk factors and the frequency of hospitalization and ER use. At admission, 27 (15.98%) respondents had been hospitalized and 19 (11.24%) required ER services during the previous 90 days. At admission, polypharmacy (β = .081, p < .01) and use of psychotropic drugs (β = -.506, p < .05) were significantly associated with frequency of hospitalization. At 1-year follow-up, cognitive impairment (β = .088, p < .05) and polypharmacy (β = .058, p < .001) had significant positive associations with frequency of hospitalization, as well as use of ER services (β = .084, p < .01; β = .077, p < .001, respectively). Use of psychotropic drugs had a negative association with frequency of ER use at both time points. Conclusion: Practitioners should periodically observe cognitive ability, polypharmacy, and use of psychotropic drugs among long-term care residents with Alzheimer's disease.