Objective: To investigate the reasons for hospital admissions for patients with Parkinson’s disease (PD) and to determine the predictors of transfer to community hospital or nursing home after discharge.

Background: Previous researches have suggested that the presence of neuropsychiatric complications, most notably hallucinations, is the strongest predictor of nursing home in PD patients. However, we identified few studies that have investigated reasons for PD inpatients being admitted next to transfer to another hospital or nursing home.

Methods: A single center retrospective study. Subjects were identified from discharge records listing primary or secondary diagnoses of PD [International classification of disease-10-CM G20] from the administrative inpatient data set of Saitama Medical University from January 2013 to September 2015. All electronic medical records of PD inpatients were consecutively reviewed.

Results: During the study period, total number of inpatients exposed to analysis was 176 (age ;71±10 years old, duration of hospitalization ;30±37 days, mean±SD), among which the primary diagnosis was PD in 58 admissions (purpose to diagnose PD, n=31; management of PD-related motor symptoms, n=19) and PD was the secondary diagnosis in 104 admissions. The common reasons for initial hospitalization were as follows; pneumonia (n = 18), reduced mobility (n = 17), gastrointestinal problems (n = 16), falls (n = 11), cardiovascular diseases (n = 5) and urinary infection (n = 4). There were only 5 with psychiatric complications as a presenting complaint. Complications of the advanced stages of PD and associated treatments are more likely to lead to hospital admission than the management of primary motor symptoms. After hospitalization, there was a reduction in those who returned to their own home from 137 (78%) to 102 (58%) with an increase in those requiring nursing home care from 14 (8%) to 20 (11%) and transfer to community hospital from 9 (5%) to 31(11%).

Conclusions: We revealed that there was an increase in discharge to community hospital or nursing home care after the hospital admission. The causes of transfers do not seem to be weighted toward neuropsychiatric complications as has been previously observed. A substantial number of admissions may be potentially avoidable with better preventive managements in the outpatients and community setting.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/predictors-of-transfer-to-community-hospital-or-nursing-home-after-discharge-of-inpatients-with-parkinsons-disease-a-japanese-single-center-retrospective-study/