Biomedical subjects

D H Frijters

Publications and source records attributed to D H Frijters.

6 recordsLinked to original sources

PubMed1998

[Nursing home day-care: a growing function for a rather stable patient group].

This article is a descriptive study of the characteristics of nursing home day-care patients in the Netherlands in 1995 at first admission and at discharge. Data were derived from the National Nursing Home Registration System (SIVIS), in which in 1995 over 85% of Dutch nursing homes participated. Newly admitted day-care patients are characterized by high age (89% older than 65 years), a distribution with (only!) 9% more women than men and a morbidity pattern of chronic somatic (cerebrovascular disease 45%) and psychogeriatric (dementia 80%) disorders. This morbidity pattern was associated with a considerable degree of disability, in particular regarding the activities of daily living and mobility. Most patients (78%) come from their own homes. The average length of stay from admittance to discharge, for both somatic and psychogeriatic day-care patients was nine months. For about 10% of the somatic patients and 40% of the psychogeriatic ones ambulatory day-care resulted in (subsequent) admission to the nursing home itself. In the last decade nursing home day-care capacity has increased rapidly and parallel to this also the number of day-care patients. Remarkably the average level of disability and the average period of treatment of nursing home day-care patients has remained approximately the same in this period.

Activities of Daily Living↗

PubMed1997

Transitions across various continuing care settings.

PURPOSE: to compare cross-nationally the sources and rates of admission and discharge in nursing homes. METHODS: data on admission were used from the Minimum Data Set of the Resident Assessment Instrument as collected in a multi-nation database at the University of Michigan. Additional data containing longitudinal episodes were used from databases in the Netherlands, Switzerland and the USA. RESULTS: the sources and rates of admission and discharge in nursing homes vary widely between countries. In Japan 47.5% of the sample was admitted from another long-term care setting, in Italy and the USA 36% and 42% respectively were admitted directly from hospital, while in Denmark and Iceland more than 60% came from home. The longitudinal data show that in the Netherlands, residents' return to home was much more likely than in Geneva or the USA (27% vs 5% vs 10%) and that in the USA a relatively large number of nursing home residents (>45%) was discharged (intermittently) to a hospital within 180 days after first admission as compared to the Netherlands (10%). CONCLUSIONS: there are large differences between countries in admission and discharge to and from nursing homes. Various policies, payment schemes, care patterns and routine referrals influence this and can be studied with cross-national data now available.

Aged↗

PubMed1995

[Characteristics of patients during their stay in a nursing home and at discharge].

OBJECTIVE: To determine the characteristics of patients during stay in nursing homes, and at the moment of discharge or death. DESIGN: Cross-sectional study. METHOD: Data were collected concerning September 30th 1991 using the National Nursing Home Registration System SIVIS, in which over 80% of the nursing homes participate. There were 45,471 patients (23,395 somatic and 22,076 psychogeriatric patients). RESULTS: Frequent morbidity consisted of stroke, neurological disorders, locomotor disorders and dementia. There was a high degree of disability regarding the activities of daily life and mobility. The average length of stay for somatic patients was just over one year, that for psychogeriatric patients almost two and a half years. After rehabilitation, one-third of the patients could be discharged to their homes or to a home for the aged. (Most of the remaining patients eventually died in the nursing home.) CONCLUSION: Residing nursing home patients are mainly characterised by chronic disorders. Consequently, disabilities and handicaps occur in many areas, such as self-care, mobility and psychological functioning. For a number of patients the distinction between somatic or psychogeriatric nursing becomes irrelevant. For all categories of patients the utilisation of care resources is increasing.

Activities of Daily Living↗

PubMed1993

[Characteristics of nursing home patients at initial admission: age, sex and morbidity].

INTRODUCTION: Some 35,000 new patients are admitted yearly to 'verpleeghuizen' or Dutch nursing homes. This paper describes some characteristics of these patients. METHOD: Data were collected using the national Nursing Home Registration System SIVIS of the Dutch centre for health care information. The response rate to the registration by the nursing homes is over 80%. RESULTS: Newly admitted nursing home patients are characterised by a (very) high age (over 50% of the patients are 80 years and over), a distribution of twice as many women as men and a morbidity pattern of chronic somatic and psychogeriatric, as well as orthopaedic disorders. CONCLUSION: Among elderly patients the nursing home patients constitute of a heterogeneous purpose of admission and morbidity pattern. Nursing home care focuses on rehabilitation, long-term care and terminal care.

Age Factors↗

PubMed1992

[Nursing care needs of nursing home patients in large cities do not explain the greater work stress on the staff].

A comparative study has been carried out to determine the influence of the care needs of patients on work pressure of nursing staff in the nursing homes of Amsterdam, Rotterdam and The Hague. Data of nursing home patients, resident at specific dates in nursing homes in the three largest cities have been compared with data from the rest of the Netherlands, altogether more than 40,000 patients at the time. The data came from the Dutch Nursing Home Information System (SIVIS). The differences have been determined in care needs and the changes in care needs in recent years. Nursing home patients in the three largest cities appear to have lower care needs than patients in the rest of the country. The care needs of the patients in the large cities hardly changed from 1986 to 1989. In the rest of the Netherlands a clear increase has occurred in the care needs of somatic and of psychogeriatric patients in the same period. The care needs of the patients in the three largest cities therefore cannot explain a higher work pressure of nursing staff as compared to the situation in nursing homes elsewhere in the Netherlands.

Activities of Daily Living↗

PubMedDate not supplied

The RAI-PC: an assessment instrument for palliative care in all settings.

Large numbers of persons in most types of healthcare settings have palliative care needs that have considerable impact on their quality of life. Therefore, InterRAI, a multinational consortium of researchers, clinicians, and regulators that uses assessment systems to improve the care of elderly and disabled persons, designed a standardized assessment tool, the Resident Assessment Instrument for Palliative Care (RAI-PC). The RAI-PC can be used for both the design of individual care plans and for case mix and outcomes research. Some elements of this instrument are taken from the resident assessment instrument (RAI) mandated for use in all nursing homes in the United States and widely used throughout the world. The RAI-PC can be used alone or in counjunction with the other assessment tools designed by the InterRAI collaboration: the RAI for homecare (RAI-HC), for acute care (RAI-AC), and for mental health care (RAI-MH). The objective of this study was to field test and carry out reliability studies on the RAI-PC. After appropriate approvals were obtained, the RAI-PC instrument was field tested on 151 persons in three countries in more than five types of settings. Data obtained from 144 of these individuals were analyzed for reliability. The reliability of the instrument was very good, with about 50 percent of the questions having kappa values of 0.8 or higher, and the average kappa value for each of the eight domains ranging from 0.76 to 0.95. The 54 men and 95 women had a mean age of 79 years. Thirty-four percent of individuals suffered pain daily. Eighty percent tired easily; 52 percent were breathless on exertion; and 19 to 53 percent had one or more other symptoms, including change in sleep pattern, dry mouth, nausea and vomiting, anorexia, breathlessness at rest, constipation, and diarrhea. The number of symptoms an individual reported increased as the estimated time until death declined. The "clinician friendly" RAI-PC can be used in multiple sites of care to facilitate both care planning and case mix and outcomes research.

Adult↗