RESEARCH PAPER
COMPREHENSIVE LONG-TERM CARE: OBSERVATIONS ON CAPACITIES, GAPS, AND INTERINSTITUTIONAL COLLABORATION
1
Department of Geriatric Nursing, Medical University of Warsaw, Poland
2
Medical Rescue Department, Medical University of Warsaw, Poland
3
Warsaw Medical University named Tadeusz Kozluk, Warsaw, Poland
4
Department of Oxyology and Emergency Care, Institute of Emergency Care, Pedagogy of Health and Nursing Sciences, Faculty of Health Sciences, University of Pecs, Pécs, Hungary
Submission date: 2025-10-11
Final revision date: 2025-11-05
Acceptance date: 2025-11-13
Publication date: 2025-11-18
KEYWORDS
TOPICS
ABSTRACT
Background:
Population aging in Poland increases demand for long-term care and intensifies contacts between residents of long-term care facilities (LTCF) and emergency medical services (EMS) and emergency departments (ED). The aim of the study was to provide a concise assessment of the clinical profile and service use in a single LTCF in 2020-2024 and to identify independent predictors of adverse outcomes.
Material and methods:
This retrospective observational study included all residents of an LTCF in the Masovian Voivodeship with 50 beds. Administrative and clinical data were analyzed for admissions, discharges, deaths, EMS interventions, and scheduled transports for diagnostics and consultations. Clinical variables included: age, gender, diagnoses coded with ICD-10, functional status.
Results:
We included 118 residents with a mean age of 84 years. More than half had dementia diagnoses. The greatest organizational burden came from scheduled transports for diagnostics and consultations, which exceeded emergency interventions.
Conclusions:
In the LTCF population, prognosis is driven mainly by advanced age and frailty severity measured by functional status. Findings support early risk stratification based on age and function as a rapid substitute for a comprehensive geriatric assessment (CGA), preference for on-site stabilization with teleconsultation when red flags are absent, and development of pathways outside the ED.
Population aging in Poland increases demand for long-term care and intensifies contacts between residents of long-term care facilities (LTCF) and emergency medical services (EMS) and emergency departments (ED). The aim of the study was to provide a concise assessment of the clinical profile and service use in a single LTCF in 2020-2024 and to identify independent predictors of adverse outcomes.
Material and methods:
This retrospective observational study included all residents of an LTCF in the Masovian Voivodeship with 50 beds. Administrative and clinical data were analyzed for admissions, discharges, deaths, EMS interventions, and scheduled transports for diagnostics and consultations. Clinical variables included: age, gender, diagnoses coded with ICD-10, functional status.
Results:
We included 118 residents with a mean age of 84 years. More than half had dementia diagnoses. The greatest organizational burden came from scheduled transports for diagnostics and consultations, which exceeded emergency interventions.
Conclusions:
In the LTCF population, prognosis is driven mainly by advanced age and frailty severity measured by functional status. Findings support early risk stratification based on age and function as a rapid substitute for a comprehensive geriatric assessment (CGA), preference for on-site stabilization with teleconsultation when red flags are absent, and development of pathways outside the ED.
REFERENCES (31)
1.
Supreme Audit Office. [Medical care for the elderly on the threshold of a demographic revolution: seminar meeting of the Supreme Audit Office College]. Kontrola Państwowa. 2016; 61(1): 5-14 (in Polish).
2.
[Order No. 55/2022/DSOZ of the President of the National Health Fund of April 25, 2022, on determining the conditions for concluding and performing contracts for nursing and care services as part of long-term care, NFZ, 2022, item 55] (in Polish).
3.
Central Statistical Office. [The situation of older people in Poland] [Internet]. Warsaw: Central Statistical Office [access 2025 Sep 24]. Avaliable from: https://stat.gov.pl/files/gfx/... (in Polish).
4.
Celiński M, Cybulski M, Fiłon J, Muszalik M, Goniewicz M, Krajewska-Kułak E, et al. Analysis of the interventions of medical emergency teams in older patients in selected Polish cities with county status: a retrospective cohort study. J Environ Res Public Health. 2021; 18(14): 7664. https://doi.org/10.3390/ijerph....
5.
Marincowitz C, Preston L, Cantrell A, Tonkins M, Sabir L, Mason S. What influences decisions to transfer older care-home residents to the emergency department? A synthesis of qualitative reviews. Age Ageing. 2022; 51(11): afac257. https://doi.org/10.1093/ageing....
6.
Lemoyne SE, Herbots HH, De Blick D, Remmen R, Monsieurs KG, Van Bogaert P. Appropriateness of transferring nursing home residents to emergency departments: a systematic review. BMC Geriatr. 2019; 19(1): 17. https://doi.org/10.1186/s12877....
7.
Zdziebło K, Stępień R, Skrzypek J. [The quality of nursing services in the opinion of long-term care patients]. Pielęgniarstwo w Opiece Długoterminowej. 2016; 1(1): 15-21 (in Polish). http://doi.org//10.19251/pwod/...).
8.
Dudziński Ł, Czyżewski Ł. Patients from nursing and residential care facilities in the practice of emergency medical teams: a two-year study. Health Prob Civil. 2025; 19(1): 17-26. https://doi.org/10.5114/hpc.20....
9.
Celiński M, Cybulski M, Fiłon J, Muszalik M, Goniewicz M, Krajewska-Kułak E, et al. Analysis of medical management in geriatric patients in the hospital emergency department by example of selected cities with county status in Poland: a retrospective cohort study. Int. J. Environ. Res. Public Health. 2022; 19(1): 48. https://doi.org/10.3390/ijerph....
10.
Furmańska-Maruszak A, Wójtewicz A. [The directions of development of long-term care services in Poland]. Studia Oeconomica Posnaniensia. 2016; 4(9): 28-42 (in Polish). https://doi.org/10.18559/SOEP.....
11.
Maciejewska MM. [Assessment of the deficit in basic activities of everyday life in relation to persons covered by residential long-term care]. Innowacje w Pielęgniarstwie i Naukach o Zdrowiu. 2021; 6(2): 7-20 (in Polish). https://doi.org/10.21784/IwP.2....
12.
[Regulation of the Minister of Science and Higher Education of July 26, 2019, on the standards of education preparing for the professions of physician, dentist, pharmacist, nurse, midwife, laboratory diagnostician, physical therapist, and paramedic (Journal of Laws 2019, item 1573)] (in Polish).
13.
[Regulation of the Minister of Health of November 22, 2013, on guaranteed nursing and care services within the framework of long-term care (Journal of Laws of 2015, item 1658, as amended)] (in Polish).
14.
Armijo-Olivo S, Craig R, Corabian P, Guo B, Souri S, Tjosvold L. Nursing staff time and care quality in long-term care facilities: a systematic review. The Gerontologist. 2020; 60(3): e200-e217. https://doi.org //10.1093/geront/gnz053.
15.
Czynsz P. [Geriatrics in an interdisciplinary approach]. Studia Toruńskie. 2023; 19(1). https://doi.org/10.56583/frp.2....
16.
World Health Organization. International Statistical Classification of Diseases and Related Health Problems (ICD-10), Volume X. Geneva: World Health Organization; 2020.
17.
Zdzieborska P, Sholokhova D, Zalewski R. Characteristics of emergency medical service (EMS) calls to mentally disabled residents of a social welfare home. Critical Care Innov. 2023; 6(3): 1-12. http://doi.org//10.32114/CCI.2....
18.
Królik PW, Rudnicka-Drożak E. [Geriatric assessment in primary health care]. Forum Medycyny Rodzinnej. 2021; 15(2): 72-80 (in Polish). http://doi.org//10.5603/fmr.74....
19.
Czyżewski Ł, Dudziński Ł, Wyzgał J. Geriatric patient in the practice of emergency medical teams – observation in 2020-2022. Front. Med. 2023; 10: 1270486. http://doi.org// 10.3389/fmed.2023.1270486.
20.
Bambach K, Southerland LT. Applying geriatric principles to transitions of care in the emergency department. Emerg Med Clin North Am. 2021; 2: 429-442. http://doi.org//10.1016/j.emc.....
21.
Guion V, De Souto Barreto P, Rolland Y. Nursing home residents’ functional trajectories and mortality after a transfer to the emergency department. Journal of the American Medical Directors Association. 2021; 22(2): 393-398.e3. https://doi.org/10.1016/j.jamd....
22.
Rousseau G, Thummel S, Vannier C, Louis MP, Debacq C, Ridoux C, et al. Evaluation of the appropriateness of nursing home residents’ transfer to emergency departments. International Emergency Nursing. 2023; 69: 101312. https://doi.org/10.1016/j.ienj....
23.
Gentili S, Emberti Gialloreti L, Riccardi F, Scarcella P and Liotta G. Predictors of emergency room access and not urgent emergency room access by the frail older adults. Front. Public Health. 2021; 9: 721634. https://doi.org 10.3389/fpubh.2021.721634.
24.
Zúñiga F, Gaertner K, Weber-Schuh SK, Löw B, Simon M, Müller M. Inappropriate and potentially avoidable emergency department visits of Swiss nursing home residents and their resource use: a retrospective chart-review. BMC Geriatr. 2022; 22(1): 659. http://doi.org//10.1186/s12877....
25.
Binert-Kusztal Ż, Starek M, Dąbrowska M. [Neurodegenerative diseases; pharmacotherapeutic aspect of Alzheimer’s diseases]. Farmacja Polska. 2021; 77(7): 451-457. http://doi.org//10.32383/farmp....
26.
Sullivan J, Mirbahai L, Lord JM. Major trauma and acceleration of the ageing process. Ageing Res Rev. 2018; 48: 32-39. https://doi.org/10.1016/j.arr.....
27.
Beaudart C, Dawson A, Shaw SC, Harvey NC, Kanis JA, Binkley N, et al. Nutrition and physical activity in the prevention and treatment of sarcopenia: systematic review. Osteoporos Int. 2017; 28(6): 1817-1833. https://doi.org/10.1007/s00198....
28.
Rezaei-Shahsavarloo Z, Atashzadeh-Shoorideh F, Gobbens RJJ, Ebadi A, Ghaedamini Harouni G. The impact of interventions on management of frailty in hospitalized frail older adults: a systematic review and meta-analysis. BMC Geriatr. 2020; 20(1): 526. http://doi.org// 10.1186/s12877-020-01935-8.
29.
Angulo J, El Assar M, Álvarez-Bustos A, Rodríguez-Mañas L. Physical activity and exercise: strategies to manage frailty. Redox Biol. 2020; 35: 101513. https://doi.org/10.1016/j.redo....
30.
Liu G, Ge R and Zhu H. Mind-body training outperforms other physical activities in reducing frailty and enhancing quality of life in older adults: a network meta-analysis. Front. Public Health. 2025; 13: 1578791. https://doi.org/10.3389/fpubh.....
31.
Guo C, Liu S, Liu Y, Zhang M, Liu S, Zeng L, et al. Development and validation of nomogram for predicting cognitive frailty with multimorbidity: a cross-sectional study. Front Public Health. 2025; 13: 1606505. https://doi.org/10.3389/fpubh.....
Share
RELATED ARTICLE
| eISSN: | 2354-0265 |
| ISSN: | 2353-6942 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
