The outcomes of patients newly admitted to nursing homes after hip fracture.

Abstract

OBJECTIVES. The outcomes of elderly, hospitalized patients discharged to nursing homes after hip fracture were examined. METHODS. For 2624 hip fracture patients admitted to any of 43 proprietary nursing homes between 1984 and 1988, admission assessments were examined in relation to 1-month outcomes. RESULTS. Mean patient age was 82 +/- 7 y; 85% of the sample were female. Within 1 month after discharge, 24% had returned home, 12% had been rehospitalized, 3% had died, and 61% remained in the nursing home. Characteristics significantly associated with morality included disorientation, functional dependency, neurologic diagnoses, and use of cardiac medications, antidepressants, or narcotics. Rehospitalization was significantly associated with age, gender, living with someone, being ambulatory, and functional dependency. Returning home was associated with younger age, living with someone, being ambulatory, and having no disorientation, functional dependency, or psychiatric or neurologic diagnoses, nor any pressure sores. CONCLUSIONS. Better-functioning persons and those with social support returned home; physically and cognitively impaired persons and those taking narcotics, cardiac medications, or antidepressants were likely to die; and younger men, those with social support, those with functional dependency, and those who were free of disorientation were more likely to be rehospitalized.

Impact of the Medicare Catastrophic Coverage Act on Nursing Homes

“…National Health Corporation, a for-profit organization that owned or managed 82 nursing homes in nine southeastern states as of 1986 (48 homes were continuously owned in the study period), has maintained computerized resident assessment data since 1974 and has made these data available for research purposes (Intrator et al 1996;Kiel et al 1994;Mor, Intrator, and Laliberte 1993). The data are derived from assessments conducted at admission, at an interval of one to three months postadmission, and on a periodic basis during residency (ranging from monthly to quarterly, depending on level of care).…”

Prevalence of Pressure Ulcers by Race and Ethnicity for Older Adults Admitted to Nursing Homes

“…Treatment of a Stage 4 ulcer averages over $124,000 per patient (Brem et al, 2010). The prevalence of PUs among nursing home (NH) admissions has been reported to be 10%-33% (Capon, Pavoni, Mastromattei, & Di Lallo, 2007; Baumgarten et al, 2004; Brandeis, Morris, Nash, & Lipsitz, 1990; Kiel, Eichorn, Intrator, Silliman, & Mor, 1994; Sternberg, Spector, Kapp, & Tucker, 1988; Zulkowski, 1998). Due to the difficulty in reliably identifying the least severe Stage 1 PUs (DeFloor & Schoonhoven, 2004), some studies exclude this stage (Baumgarten et al, 2004; Brandeis et al, 1990) or report Stage 1 results separately (Sternberg et al, 1988).…”

Fractura osteoporótica de cadera: Factores predictivos de recuperación funcional a corto y largo plazo

“…Oscilan, según los diferentes estudios desde el 20% al 40% al alta hospitalaria (48,62,77), entre el 25 y el 55% durante los primeros meses tras la fractura (8,49,57,78,79), el 30 al 50% a los 12 meses (8,31,36,56,78,(80)(81)(82)(83)(84)(85), 72% a lo largo de los dos primeros años tras la fractura (86) o 55% a los 3 años (87). Otros estudios con criterios de selección más estrictos de los pacientes ancianos con fractura dan unas cifras de recuperación cercanas al 90% desde los primeros meses tras la fractura (55,58,88).…”