A new study finds that about one-fourth of hospitalizations for congestive heart failure or bacterial pneumonia could have been prevented.
The authors said that the hospitalizations could have been avoided if medical care started sooner. Delays were commonly due to care supports (like family members) and clinicians, the authors said. The extent of preventability was similar whether or not the person had dementia, the authors noted. The report was published on Wednesday in the Journal of the American Geriatrics Society.
The researchers looked at medical records from a dataset on aging and dementia risk. The team focused on congestive heart failure and bacterial pneumonia because they’re the most common chronic and acute preventable admission conditions.
The team compared 15 people who had congestive heart failure and 15 who had bacterial pneumonia, then matched them to those without dementia — so the total sample size was 60 individuals (later it went down to 58 due to lack of records in two people). The mean age was 88.3 years, and 58.6% of the people were female.
Among those without dementia, evidence from eight of 29 admissions showed that ambulatory care was delayed. Among those with dementia, a similar proportion of people experienced delays in care.
“While a majority of hospitalizations reviewed did not appear preventable, one quarter may have been,” the authors said.
Efforts to reduce hospitalizations in people with dementia, whether preventable or all-cause, could include “do not hospitalize” orders. The authors advocated for more education on the decision to hospitalize, better access to “hospital-at-home” care, and hospital outreach services to optimize admissions for those who need hospitalization.
“In conclusion, this analysis suggests that relatively few “preventable” hospitalizations of older adults — at least for the conditions considered here — may actually be preventable,” the authors wrote.
