Characteristics, Trajectories, and Medication Use of Patients in Temporary Stays in Denmark

Background: Danish municipalities provide so-called “temporary stays” for patients with short-term care needs that cannot be met at home, typically frail older people who need additional support after hospital discharge before they can safely return home or be transferred to a care home. Temporary stays continue to play a growing role in the Danish healthcare system. A better understanding of the current use of temporary stays may improve the quality of care and safety for the patients.

Objectives: To describe the characteristics and medication use of patients in temporary stays in Denmark.

Methods: This was a descriptive study based on a manually assembled cohort of patients in temporary stays across 14 Danish municipalities in 2016-2022. The cohort was linked to Danish nationwide health registries to obtain information about hospital admissions and diagnoses, prescription medication use, and demographics. For patients with multiple temporary stays within the study period, we only included the first temporary stay in the analyses.

Results: We identified 14,978 temporary stays from 11,424 patients during the study period. The patients had a median age of 81 years (interquartile range [IQR] 73-87), and 54% were female. The patients had a median Charlson Comorbidity Index of 2 (IQR 1-4) and a median of 3 hospital admissions (IQR 2-6) in the year before move-in. Within one month and one year after move-in, 14% and 38% had died, respectively. The median length of a temporary stay was 24 days (IQR 11-49). The patients used a median of 7 drug classes (IQR 4-10) in the four months before move-in. The most frequently used drug classes were paracetamol (49%), statins (30%), proton pump inhibitors (29%), antiplatelets (26%), and selective beta blockers (23%). The majority of the patients used at least one risk medication in the four months before move-in (82%), with the most frequent ones being diuretics (36%), angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) (33%), and opioids (30%). The monthly rate of incident medication use increased from about 20 drug classes per 100 patients at 12-24 months before move-in to a peak of 267 drug classes per 100 patients in the month after move-in and then decreased to a slightly lower level than before move-in after 6 months. The main drug classes contributing to the incidence rate peak were analgesics, laxatives, and antibiotics.

Conclusions: Patients in temporary stays are generally older people with multimorbidity and using a considerable number of medications. Medication initiation increases sharply after moving into a temporary stay facility. Our findings can guide efforts to promote rational medication use and improve care among this patient population.