Effects of Functional Status Changes Before and During Hospitalization on Nursing Home Admission of Older Adults

Fortinsky, Richard H.; Covinsky, Kenneth E.; Palmer, Robert M.; Landefeld, C. Seth

doi:10.1093/gerona/54.10.m521

Cited by 245 publications

(182 citation statements)

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“…These latter characteristics were largely identified in the literature on nursing home admissions. The individual characteristics that this literature leads one to expect might affect departure from an ALF are largely those associated with cognitive status, functional dependency, and a variety of health conditions (Black, Rabins, & German, 1999;Coward, Horne, & Peek, 1995;Fortinsky, Covinsky, Palmer, & Landefeld, 1999;Rudberg, Sager, & Zhang, 1996).…”

Section: Analysis Variablesmentioning

confidence: 99%

Effects of Facility Characteristics on Departures From Assisted Living: Results From a National Study

Phillips¹,

Muñoz²,

Sherman³

et al. 2003

The Gerontologist

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Purpose: Assisted living is an increasingly important residential setting for the frail elderly person. How often and why residents leave such facilities are important issues for consumers, for clinicians advising frail patients on their options for living arrangements, and for policymakers. This research investigated the impact of facility and individual characteristics on residents' departures from assisted living. Design and Methods: This research is based on data on 1,483 residents in a nationally representative sample of 278 assisted living facilities (ALFs). Analyses of these data from 1998 and 1999 especially focused on those residents who left a study ALF between baseline and follow-up data collection. Multinomial logit models were estimated to investigate the impact of facility and individual factors on residents' status at follow-up. Results: Over three quarters of those leaving their baseline ALF did so because they needed more care. The multivariate analyses indicated that poorer functional status and being married affected residents' relative odds of death before follow-up. Moving to another setting, other than a nursing home, was more likely for residents in for-profit ALFs. Functional status, cognitive status, and the presence of a full-time RN affected residents' odds of moving from an ALF to a nursing home. Implications: Both facility-level and individual-level factors affected residents' relative odds of leaving an ALF. The findings with the most potentially interesting policy implications are those concerning the factors that affected residents' relative likelihoods of entering a nursing home.

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Section: Analysis Variablesmentioning

confidence: 99%

Effects of Facility Characteristics on Departures From Assisted Living: Results From a National Study

Phillips¹,

Muñoz²,

Sherman³

et al. 2003

The Gerontologist

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“…3 Decline in health status during hospitalization has important consequences in terms of quality of life and healthcare utilization as it has been associated with the risk of longer hospital stay, institutionalization, and mortality. 4,5 Availability of objective and standardized tools to assess and track health status changes during hospitalization is of great importance for appropriate management and to properly monitor the effect of medical therapy. 6 Nevertheless, the ability of medical diagnoses and traditional clinical assessment to discriminate heterogeneous patients is limited.…”

mentioning

confidence: 99%

Change in the Multidimensional Prognostic Index Score During Hospitalization in Older Patients

Volpato

Daragjati

Simonato

et al. 2016

Rejuvenation Research

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on behalf of the MPI-TriVeneto Study Group * AbstractWe investigated and describe change in the Multidimensional Prognostic Index (MPI) score between admission and discharge in 960 older patients admitted to 20 geriatric units for an acute disease or a relapse of a chronic disease. The MPI was calculated at admission and at discharge. Subjects were divided into three groups of MPI score, low risk (MPI-1 value £0.33), moderate risk (MPI-2 value 0.34-0.66), and severe risk of mortality (MPI-3 value ‡0.67), on the basis of previously established cutoffs. Variation of MPI values over length of hospital stay (LOS) was analyzed with a multivariable longitudinal linear model for repeated measurements. At admission, 23.5% subjects had an MPI-1 score, 33.3% had an MPI-2 score, and 43.0% had an MPI-3 score. Overall, for almost 60% of the patients, MPI score at hospital discharge was different compared with the score at admission, although the difference was not statistically significant (-0.003; p = 0.708). Patients with high and intermediate MPI scores at admission had a decrease of MPI score at discharge (delta-MPI -0.026, p < 0.001, and delta-MPI -0.066, p = 0.569, respectively), whereas patients in the MPI-low group, experienced a significant increase in MPI score (delta-MPI 0.041, p < 0.001). The evolution of MPI score as a function of LOS had a curvilinear shape because it significantly decreased for patients with short hospitalization (1-6 days) and tended to increase for those with longer LOS. The MPI, a well-established prognostic tool, is sensitive to change of patient's health status and might be used to objectively track and monitor the clinical evolution of acutely ill geriatric patients admitted to the hospital.

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“…La incidencia de deterioro funcional al alta hospitalaria en mayores de 65 años está en torno al 30% 23,24 . Las consecuencias de ello son relevantes tanto para el paciente como para el sistema sanitario, dado que el deterioro funcional es un factor de riesgo destacado tanto de mortalidad como de institucionalización, así como de consumo de recursos sanitarios y sociales a corto y medio plazo 25,26 . Como hemos observado en el estudio, las causas de dicho deterioro pueden derivar diJosé Manuel Corrales Pérez, María del Carmen Águila Pollo, Margarita Vázquez Aguilera, Sarah Jayne Grantham, Antonio Ramos Sánchez y Ana Sofía Fernandes Ribeiro Repercusión de las heridas crónicas en las unidades de rehabilitación funcional …”

Section: Discussionunclassified

Repercusión de las heridas crónicas en las unidades de rehabilitación funcional

Pérez¹,

Pollo²,

Aguilera³

et al. 2015

Gerokomos

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Effects of Functional Status Changes Before and During Hospitalization on Nursing Home Admission of Older Adults

Cited by 245 publications

References 0 publications

Effects of Facility Characteristics on Departures From Assisted Living: Results From a National Study

Effects of Facility Characteristics on Departures From Assisted Living: Results From a National Study

Change in the Multidimensional Prognostic Index Score During Hospitalization in Older Patients

Repercusión de las heridas crónicas en las unidades de rehabilitación funcional

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