Résumé :
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[BDSP. Notice produite par INIST-CNRS BhP1R0xa. Diffusion soumise à autorisation]. Due to the fundamental importance of the quality dimension in nursing homes and the increasing concern of the government and the residents themselves regarding improper hospital use, a study was initiated to evaluate the prevalence of hospitalizations during the entire length of residency in nursing homes. In Flanders the case-mix of'standard'nursing home residents is the same (age, gender, level of disability and pathology type) - does this yield a comparable profile for hospital referrals ? Based on a convenience sample we retrospectively describe the entire hospital history (total n=324 hospitalizations) of each deceased resident (n=265 ; 190 women and 75 men) during the calendar year 2000 in seven institutions in Flanders. Of the 265 screened residents, 65% was sent to the hospital at least once during their stay in the home ; 31% twice, 13% three times and 6% more than three times. The percentage varies per institution from 44 to 80%. The mean number of hospital days was 14.9 (SD 12.4) and ranges between 10 and 16.8 (SD 7.2 to 15.4). No significant difference in length of hospital stay was found (F=0.634 ; p=0.70) nor any gender-related difference (chi square 0.399 ; p=0.53). The most important reason for hospitalization was observation (53%), especially after respiratory and gastro-intestinal complaints. Further down the line there were fractures (15% [mainly hip]), surgery (11%), stroke (11%), and terminal hospitalizations (7%). Assuming there were no global differences in residents'characteristics between the different homes, this study found remarkable differences in hospitalization referrals. We suggest that hospitalization is not only determined by medical factors but also by the home policy (structure and culture) and the general practitioners'attitude.
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