Sociodemographic Factors and Characteristics of Caregivers as Determinants of Skilled Nursing Facility Admissions When Modeled Jointly With Functional Limitations.
Terese Sara Høj Jørgensen, Heather Allore, Janet L MacNeil Vroomen and 2 others
PMID 30902676WHAT IT FOUND
In older Medicare adults, each one-point worsening on a 7 to 28 function scale was associated with 26% higher likelihood of skilled nursing facility admission.
Living alone, low education, and more caregivers also raised risk.
Key findings
01Each one-point worsening in functional limitations was associated with a 26% higher hazard of first skilled nursing facility admission.
02Non-Hispanic white race, less than 9th grade education, and more caregivers were associated with higher skilled nursing facility admission hazards, while living with a partner or others was associated with lower hazards.
03Among people with a caregiver, a medical-supportive caregiver was associated with worsening function and higher skilled nursing facility admission, while a partner caregiver was associated with lower admission.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study was observational, so it cannot show that any factor caused skilled nursing facility admission. There may be residual confounding despite joint modeling and inclusion of health status measures. The sample was limited to Medicare fee-for-service beneficiaries, which may reduce generalizability. Missing follow-up data were due to death and loss to follow-up and were handled with weights; the weighted analysis used 1583 cases between rounds 1 and 2.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read these factors as causes of skilled nursing facility admission. The study was observational, and a medical-supportive caregiver may reflect unmet health needs rather than causing admission.