Hospital deaths among long-term care insurance users living in the community and reasons for repeated emergency transport and post-discharge care: a survey on care managers

Abstract

【Introduction】The purpose of this study was to clarify the situation of hospital deaths of long-term care insurance users living in the community, the reasons of users repeatedly hospitalized by emergency transport and post-discharge care from care managers to examine how elderly people can live until the end of their lives in their familiar communities. 【Methods】164 care managers in City B responded to the anonymous online survey in FY2022. Of these, 133 respondents who reported a death among users were included in the analysis. 【Results】About 80% of the respondents answered that they had a patient who died in the hospital, and 23 responded that those wished to receive end-of-life care at home. Approximately 40% of respondents reported having users who were repeatedly admitted to the hospital by ambulance, of whom 50% reported having no visiting medical consultation services and 30% reported having visiting nursing services. Reasons for emergency care included worsening heart failure, aspiration pneumonia, fractures due to falls, and anxiety. Intentions for emergency transport were confirmed and ACP was performed. 【Conclusions】 There were many hospital deaths. To reduce the number of patients who died in hospital against their wishes, it is necessary to strengthen the cooperation between medical and nursing care in dealing with deteriorating conditions and to reduce the anxiety of people living alone and their families in emergency situations.