Premature deaths of nursing home residents: an epidemiological analysis.

OBJECTIVES To conduct a descriptive epidemiological analysis of external cause deaths (premature, usually injury-related, and potentially preventable) of nursing home residents in Australia. DESIGN Retrospective study of a cohort of nursing home residents, using coronial data routinely recorded by the National Coronial Information System. SETTING AND PARTICIPANTS Residents of accredited Australian nursing homes, whose deaths were reported to coroners between 1 July 2000 and 30 June 2013, and determined to have resulted from external causes. MAIN OUTCOME MEASURES Causes of death, analysed by sex and age group, and by location of incidents leading to death and location of death. Rates of death were estimated on the basis of Australian Bureau of Statistics population and Australian Institute of Health and Welfare nursing home data. RESULTS Of 21672 deaths of nursing home residents, 3289 (15.2%) resulted from external causes. The most frequent mechanisms of death were falls (2679 cases, 81.5%), choking (261 cases, 7.9%) and suicide (146 cases, 4.4%). The incidents leading to death usually occurred in the nursing home (95.8%), but the deaths more frequently occurred outside the nursing home (67.1%). The annual number of external cause deaths in nursing homes increased during the study period (from 1.2 per 1000 admissions in 2001-02 to 5.3 per 1000 admissions in 2011-12). CONCLUSION The incidence of premature and potentially preventable deaths of nursing home residents has increased over the past decade. A national policy framework is needed to reduce the incidence of premature deaths among Australians living in nursing homes.