by Claudio Canal, Anne-Sophie Mittlmeier, Valentin Neuhaus, Hans-Christoph Pape, Mathias Schlögl
Abstract
Methods: We examined a quality measurement database containing de-identified cases from across Switzerland.
All patients with a complete dataset treated between 2015 and 2021 were included. A case-control matching
method (same age, comorbidity, sex, diagnosis, admission type, and insurance coverage) was used to evaluate
the impact of pre-admission residence. The outcomes measured included complications during hospitalization,
in-hospital mortality, and length of stay. Statistical significance was set at a p-value of <0.001 due to our large
size of analyzed cases.
Results: We noted a higher prevalence of comorbidities and higher ASA scores among the 2130 (1.9 %) patients
admitted from long-term care facilities (LTCFs). Complication rates in the LTCF group were higher than those in
the home group (15 % vs. 6.9 %, p = <0.001). Pneumonia was the most frequent complication in both groups.
The in-hospital mortality rate was also significantly higher in the LTCF group than the home group (5.8 % vs. 1.1
%, p = <0.001). However, matched-pair analysis showed no significant difference in complication rates and
overall mortality between the two groups. Patients admitted from LTCFs even had a shorter hospital stay (7.5 ±
8.7 days vs. 8.9 ± 7.9 days, p = <0.004).
Conclusions: Despite higher complication and mortality rates among LTCF patients, the matched-pair analysis
showed no significant differences in these rates between the two groups. However, patients from LTCFs were
discharged earlier, indicating the effectiveness of Switzerland’s care system for older adults living in nursing
homes.