Introduction hospital transfers and admissions are critical events in the care of nursing home residents. We sought to determine hospital transfer rates at different ages. Methods a cohort of 1,187 long-stay nursing home residents who had participated in a Centers for Medicare and Medicaid demonstration project. We analysed the number of hospital transfers of the study participants recorded by the Minimum Data Set. Using a modern regression technique, we depicted the annual rate of hospital transfers as a smooth function of age. Results transfer rates declined with age in a nonlinear fashion. Rates were the highest among residents younger than 60 years of age (1.30-2.15 transfers per year), relatively stable between 60 and 80 (1.17-1.30 transfers per year) and lower in those older than 80 (0.77-1.17 transfers per year). Factors associated with increased risk of transfers included prior diagnoses of hip fracture (annual incidence rate ratio or IRR: 2.057, 95% confidence interval (CI): [1.240, 3.412]), dialysis (IRR: 1.717, 95% CI: [1.313, 2.246]), urinary tract infection (IRR: 1.755, 95% CI: [1.361, 2.264]), pneumonia (IRR: 1.501, 95% CI: [1.072, 2.104]), daily pain (IRR: 1.297, 95% CI: [1.055,1.594]), anaemia (IRR: 1.229, 95% CI [1.068, 1.414]) and chronic obstructive pulmonary disease (IRR: 1.168, 95% CI: [1.010,1.352]). Transfer rates were lower in residents who had orders reflecting preferences for comfort care (IRR: 0.79, 95% CI: [0.665, 0.936]). Discussion younger nursing home residents may require specialised interventions to reduce hospital transfers; declining transfer rates with the oldest age groups may reflect preferences for comfort-focused care.

中文翻译：

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长期入住疗养院居民的不同年龄的医院转移率

介绍 医院转院和入院是疗养院居民护理中的关键事件。我们试图确定不同年龄的医院转移率。方法 1,187 名长期入住疗养院居民的队列参与了医疗保险和医疗补助示范项目的中心。我们分析了最小数据集记录的研究参与者的医院转移次数。使用现代回归技术，我们将医院转移的年率描述为年龄的平滑函数。结果转移率随着年龄的增长呈非线性下降。60 岁以下居民的比率最高（每年 1.30-2.15 次转账），60 至 80 岁（每年 1.17-1.30 次转账）相对稳定，80 岁以上的居民较低（每年 0.77-1.17 次转账） . 与转移风险增加相关的因素包括髋部骨折的先前诊断（年发病率比或 IRR：2.057，95% 置信区间（CI）：[1.240，3.412]）、透析（IRR：1.717，95% CI：[1.313] , 2.246]), 尿路感染 (IRR: 1.755, 95% CI: [1.361, 2.264]), 肺炎 (IRR: 1.501, 95% CI: [1.072, 2.104]), 日常疼痛 (IRR: 1.297, 95% CI: [1.055,1.594])、贫血 (IRR: 1.229, 95% CI [1.068, 1.414]) 和慢性阻塞性肺疾病 (IRR: 1.168, 95% CI: [1.010,1.352])。接受反映舒适护理偏好的订单的居民的转移率较低（IRR：0.79，95% CI：[0.665，0.936]）。讨论 年轻的疗养院居民可能需要专门的干预措施以减少医院转移；最老年龄组的转移率下降可能反映了对以舒适为重点的护理的偏好。