Hospitalization Management in Long-Term Care Settings

Hospitalization management in long-term care settings encompasses the processes by which residents of nursing homes, assisted living facilities and other residential care environments are assessed, transferred and cared for when acute medical needs arise. Older adults in these settings often present with multimorbidity, frailty and cognitive impairment, making them particularly vulnerable to the adverse effects of hospital admission, including functional decline, delirium and hospital‐acquired complications. Effective management requires advance care planning, clear goals of care and interprofessional decision‐making that balances clinical benefit against the risks of transfer. Strategies to reduce unnecessary transfers include enhancing on‐site clinical capability through advanced practice nursing, telemedicine consultations and mobile diagnostics, as well as structured triage protocols and rapid access to primary or specialist input. Collaborative networks linking long‐term care facilities, general practitioners, emergency departments and specialist teams support continuity, timely assessment and appropriate disposition. Standardised assessment tools, robust communication pathways and targeted staff education are key to ensuring safe, resident‐centred decisions. With ageing populations exerting pressure on health systems worldwide, evidence‐based interventions that integrate acute care into the long‐term setting or provide hospital‐at‐home services have become central to sustainable, high‐quality care models.

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Hospitalization Management in Long-Term Care Settings publication trend

The graph below shows the total number of articles in hospitalization management in long-term care settings across all publications each year (not limited to Nature Index journals).

Technical terms

Long-term care settings: Residential facilities that provide ongoing nursing, personal and rehabilitative care to individuals with chronic illness or disability.

Emergency department (ED): A hospital unit providing immediate treatment for acute illnesses and injuries.

Advance directives (ADs): Legal documents outlining a person’s preferences for medical treatment in the event they cannot communicate their wishes.

Geriatric syndromes: Multifactorial health conditions common in older adults, such as falls, delirium and incontinence, that do not fit into discrete disease categories.

Nurse practitioner (NP): An advanced practice registered nurse with expanded clinical training authorised to assess, diagnose and manage patient care, including prescribing medicines.

References

1. Variations in older people’s emergency care use by social care setting: a systematic review of international evidence. British Medical Bulletin (2023).
2. Appropriateness of transferring nursing home residents to emergency departments: a systematic review. BMC Geriatrics (2019).
3. Hospital in the Nursing Home program reduces emergency department presentations and hospital admissions from residential aged care facilities in Queensland, Australia: a quasi-experimental study. BMC Health Services Research (2015).
4. Assessment tools for determining appropriateness of admission to acute care of persons transferred from long-term care facilities: a systematic review. BMC Geriatrics (2014).
5. The Impact of Nurse Practitioners on Hospitalizations and Discharges from Long-term Nursing Facilities: A Systematic Review. Healthcare (2020).
6. Interprofessional collaboration in nursing homes (interprof): development and piloting of measures to improve interprofessional collaboration and communication: a qualitative multicentre study. BMC Primary Care (2018).