Impact of regular televisits on unplanned hospital admissions of nursing home residents in rural Germany: a pre-post intervention study

BACKGROUND Hospital admissions occur frequently in nursing homes and are often preventable. Inappropriate hospitalizations due to ambulatory care sensitive conditions bring major risks for the residents, put the emergency departments under pressure and generate high costs for the health sector. Telemedical solutions are of great potential to intensify medical follow-up of the residents and therefore reduce hospital admissions. In this study, we evaluated whether the implementation of regular medical televisits, in addition to on-site nursing home visits, can reduce unplanned hospital admissions. METHODS In 2021 a nursing home in rural Germany introduced a telemedical system, linking the facility to a general practitioner. Data concerning the unplanned hospitalizations of the residents was collected for 2021/22 and for 2018/19, serving as pre-intervention comparison. Thereafter, hospital admissions were compared between the two time periods, and between residents of 2021/22 who did or did not receive regular televisits by their general practitioner. RESULTS Baseline characteristics were comparable between residents of 2018 and 2021, as well as between residents of 2021 receiving or not telemedical care. Unplanned hospital admissions had significantly decreased (P < .0001) after implementation of regular televisits. Furthermore, a significantly lower (P = .04) number of hospital admissions was noted among residents benefiting from regular televisits by their general practitioner, compared to the control group solely followed by regular on-site nursing home visits. CONCLUSIONS The successful implementation of a telemedical system providing ambulatory care in nursing homes shows promising results to reduce unplanned hospital admissions and possibly avoid its negative consequences. TRIAL REGISTRATION Not applicable, as no healthrelated intervention, modifying biomedical outcome or healthrelated measures in patients, took place.