Health Outcomes From Assisted Living Facilities: A Cohort Study of a Primary Care Practice.
Mairead M Bartley, Stephanie M Quigg, Anupam Chandra and 1 others
PMID 32774179WHAT IT FOUND
Assisted living residents were twice as likely to be hospitalized and more likely to die within a year compared with matched community dwellers.
They also had more emergency visits and falls, and more residents had advance care documents.
Key findings
01Assisted living residents were twice as likely as matched community dwellers to have at least one hospitalization within a year (odds ratio 2.03, 95% CI 1.5 to 2.7).
02Assisted living residents had higher odds of emergency department visits and falls than community dwellers (odds ratio 2.25 and 2.42), and this remained significant after correcting for comorbid conditions.
03Assisted living residents had higher 1-year mortality than controls (20.3% vs 9.4%), with unadjusted odds ratio 2.5 and adjusted odds ratio 1.7.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was retrospective, so it could not prove that assisted living caused the outcomes. The authors said they did not have measures for activities of daily living, falls, or standardized cognitive assessment. Residents were identified manually, so not all assisted living residents in Rochester were captured. Most participants were white, typical of the local area, so results may not apply to more diverse populations. The study had no direct measure of socioeconomic status or caregiver status and used marital status as a proxy.
Declared interests
The supplied text reports that Paul Y. Takahashi, MD, serves on the medical board for Axiall LLC.
The easy way to misread this
Do not conclude that assisted living itself causes hospitalization, death, falls, or emergency visits. The study compared assisted living residents with matched community dwellers retrospectively, and the groups differed in comorbid conditions and marital status, which was used as a caregiver proxy, so it shows association, not cause.