Causes of hospital admissions in people with dementia. Qualitative interviews with relatives of demented patients and professionals from the medical field

• Applicant: Dr. Marion Eisele
• Subject Area: Public Health, Healthcare Research, Social and Occupational Medicine
• Term: from 2013 to 2015
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 232311051

International studies have shown that patients suffering from dementia have a significantly increased risk of hospital admissions compared to the population without dementia, although dementia itself does not primarily result in hospital admission. This leads to both an increase of burden and costs in individuals with dementia. Moreover, the structural prerequisites of most hospitals do not meet the special needs of patients with dementia. Therefore, the number of hospital admissions in dementia should be kept as low as possible. In a majority of the studies, which examined the influencing factors of hospital admissions in individuals with dementia, the discharge diagnoses of hospital claims data were analysed. However, those diagnoses do not necessarily reflect the actual clinical condition, due to which a patient was admitted. Other studies have examined a pre-selected choice of potential influencing factors in a quantitative study design. Most of those studies focused on personal determinants.In the model of Kendall and Muenchberger considering influencing factors of hospital admissions of chronically ill patients, besides personal determinants further determinants like system and environmental factors are listed. Those could be of special importance within the care of individuals with dementia.As yet, no study has investigated to the causes of hospitalisation by an exploratory approach and examined those for potential preventability. Therefore the aim of this project is to investigate the causes of hospital admissions of people with dementia in an exploratory study design and to examine its potential preventability.A total of 12 dementia patients will be identified. For each patient two open guided interviews regarding the causes of the last hospital stay, as well of the potential preventability of those, will be conducted: one with a relative and one with a professional. The patients will be identified by selective sampling from an existing cohort of people with dementia. The interviews will be recorded, transcribed and analyzed on the basis of qualitative content analysis by Mayring. The basic category system is deductively derived from an existing theoretical model and will be expanded by inductively formed categories as new findings emerge from the data.At the end of the project we will be able to shed light on the causes of hospital admissions and will have information on their potential preventability. In a follow-up project the causes will be quantified. The future perspective is to develop and test interventions for the prevention of hospital admissions in individuals with dementia.

• DFG Programme: Research Grants