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In the present study, data were derived from two sources: the RNs' documentation and the cross-sectional follow-up study database built on RAI/MDS assessments [24]. The RAI/MDS focuses on patients' functional capacity, resources and needs, is internationally Cobimetinib cell line established, valid and reliable [25, 26] and provides a comprehensive assessment of older patients receiving health care [25-27]. During the follow-up period, all referrals to ED were registered and reported by the RN involved to a research assistant. The RN copied and faxed the documentation from the nursing journal to the research assistant. The documentation described the reason for referral and during what time of the day the referral occurred The RNs' documentation of the problems occurring prior to the referrals is not equivalent to a medical diagnosis. Before the start of the assessments, interested enrolled nurses, RNs and physiotherapists (N?=?150) from the 24 NHs were trained in how to use the assessment instrument by the research team. Thereafter, these care providers carried out baseline as well as follow-up assessments after 1?year. The RAI/MDS data as well as the RNs' documentation were analysed Cell Cycle inhibitor using the statistical software package spss 18.0 (SPSS Inc., Chicago, IL, USA). Descriptive statistics are given as frequencies, percentages, mean?��?SD. In addition, Student's t-test, chi-squared tests and logistic regressions were used. A p-value?Bumetanide reasons for referrals were marked and coded. The codes were grouped according to similarities and sorted into fifteen groups, representing the most common in the text. The codes and groups were discussed with the co-authors during the analysis process until agreement was reached. Thereafter, the groups were inserted to the database. Potential background factors and possible predictors for referrals to an ED were included in a logistic regression model, with referred or not referred as the dependent variable. The covariates measured at baseline were age, gender, duration in NH living, Body Mass Index (BMI), thirteen different diagnostic groups according to the RAI/MDS classification, multimorbidity, number of drugs, types of drugs, previous fall episodes, infections and 21 different clinical symptoms and problems. Of the 719 persons, 209 (29%) were referred to an ED 314 times during the 1-year study period (1.5 visits per referred person). The number of referrals ranged between one and seven, where 71% had only one referral.