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Background and Methods: Research into acute hospital admissions (AHAs) of hospice patients is relatively underdeveloped. The goal of this study, based on the electronic health records (EHR) of a large Midwestern hospice service over a 3-year period, was to identify characteristics of new hospice patients that are associated with an increased risk of later AHAs. Results: Our study of a large and undifferentiated hospice population revealed several important new findings regarding AHA. We found these previously unreported factors associated with elevated AHA rates: 1) hospice diagnoses of terminal heart and lung disease compared with other diagnoses; and 2) the home care setting compared with the nursing home setting. Moreover, previous studies had not looked in detail at the timing of AHA over the course of hospice care or related the timing of AHA to the reason for AHA. Conclusions: The future agenda for research on AHA of hospice patients should include studies of large and undifferentiated hospice populations like our own, but designed to capture data on socioeconomic status (SES), religion, race/ethnicity, the details of supportive care in place, and a look at specific factors surrounding individual AHAs. [ABSTRACT FROM AUTHOR]

Purpose. The association between fall risk and inpatient medications was evaluated. Methods. A retrospective, case-control study was performed to compare the medication use of patients sustaining at least one fall during hospitalization (case group) with a control group of patients who did not fall. Data were collected from medical records and generated reports. A fall was defined by the hospital as an event in which the patient comes to rest on the floor from a lying, standing, or sitting position. Adult patients ( 18 years of age) admitted between January 1 and December 31, 2006, experiencing a fall at least 48 hours after hospital admission were included in the case group. Each case was matched with one control by age (within five years), sex, admission date (within 30 days), patient care unit, and length of stay. Medications administered within 48 hours before the fall for the case group or designated fall date and time for the control group were documented. Results. Of the 414 documented fall events, 209 patients met the inclusion criteria. Of those patients, 96 matched control patients on all criteria. Significantly more case patients received a greater number of central nervous system (CNS) agents compared with matched control patients (p = 0.017). There was no statistically significant difference in the number of medications from all other drug classes or the total number of medications received by the groups. Conclusion. In a sample of hospitalized patients, CNS agents were significantly associated with falls. [ABSTRACT FROM AUTHOR]