From the nursing home to hospital and back again... a mixed methods study on hospital transfers from nursing homes

Hospital transfers from nursing homes are frequent, costly, often preventable, and can have negative effects on the residents' health. The present study investigated the current situation in Carinthia (Austria) regarding the characteristics of relocated nursing home residents, the proportion of avoidable transfers, the consequences of relocation from the physicians' and nurses' perspectives and ways for improving nursing home care. Retrospectively, the documentations of a regional hospital (N = 4149), a rescue service (N = 10754), and a social insurance agency (N = 7051) were analysed; qualitative interviews with physicians (N = 25) and nursing administrators (N = 16) were conducted. A considerable proportion of these transports seemed to be avoidable: for example, about 40% of the ambulatory treatments in the emergency department of the investigated hospital were inappropriate. Options for improving the current situation will be discussed.