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

Abstract

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.

Keywords:

• Alzheimer's disease
• long-term care facilities
• Hong Kong
• hospitalization
• emergency room

Acknowledgements

The authors wish to acknowledge the invaluable contribution of the participants of the study. Special thanks go to Hong Kong Sheng Kung Hui Council Welfare for their kind support in data collection.