Multiple Chronic Conditions and Hospitalizations Among Recipients of Long-Term Services and Supports.
Janet H Van Cleave, Brian L Egleston, Katherine M Abbott and 3 others
PMID 27801713WHAT IT FOUND
In older adults newly receiving long-term services and supports, a condition group dominated by heart and lung disease, especially congestive heart failure, was associated with more hospitalizations than a lower-condition group.
Key findings
01Among older LTSS recipients, membership in the Cardiopulmonary condition class was associated with more hospitalizations than membership in the All Other Conditions class (RR 1.88, 95% CI 1.33 to 2.65).
02The Cardiopulmonary class was marked by congestive heart failure (92%), myocardial infarction (54%), and pulmonary disease (41%).
03Higher depressive symptom scores and nursing home residence compared with assisted living were associated with more hospitalizations (RR 1.04 and RR 1.56).
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 observational. It cannot show that cardiopulmonary conditions caused hospitalizations or that managing them would prevent admissions. Records did not distinguish active conditions from historical ones, so all conditions were counted as present at enrollment. People who could not communicate in English or Spanish or who had severe cognitive impairment were excluded. This may mean dementia-related risk is underestimated. The sample came from a convenience set of sites in three northeastern U.S. states. It may not represent other long-term services and supports populations. Hospitalization data came from records. Chronic conditions were underreported for some home and community-based participants because agency forms had limited recording space. When both the condition-group method and the Charlson Comorbidity Index were modeled together, the Cardiopulmonary group association became nonsignificant.
Declared interests
The authors reported no conflicts of interest. The parent study used data funded by the National Institute on Aging.
The easy way to misread this
Do not read the higher hospitalization rate as proof that cardiopulmonary conditions caused admissions or that treating them would prevent admissions. This was an observational record-based analysis, and the condition-group association became nonsignificant when the Charlson Comorbidity Index was added to the same model.