Trajectories Over the First Year of Long-Term Care Nursing Home Residence.
Shuang Li, Addie Middleton, Kenneth J Ottenbacher and 1 others
PMID 29108886WHAT IT FOUND
Within one year of long-term care nursing home admission, 35.0% died, 36.9% remained in nursing home, and 23.4% were living in the community. 30.6% moved repeatedly between nursing home, hospital and other facilities.
Key findings
01At one year after admission, 36.9% of residents were in a long-term care nursing home, 23.4% were in the community, and 35.0% had died.
02Over the first year, 33.4% were discharged to the community, but 19.9% of those discharged died before follow-up ended.
0330.6% experienced multiple transitions; a common repeated path was nursing home to acute hospital, then to skilled nursing, rehabilitation or long-term acute care, then back to nursing home.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only the first four transitions in the year were examined, so later moves are not captured. The cohort was limited to people with continuous Medicare fee-for-service enrollment, so findings may not apply to Medicare HMO members or residents covered by other payers. The study describes administrative trajectories and did not test any treatment or care model.
Declared interests
The authors report no financial or personal conflicts of interest.
The easy way to misread this
Do not read community discharge as a stable return home. Among residents discharged to the community at the first transition, 43.7% stayed in the community, 11.3% were readmitted to long-term care, 34.4% were admitted to acute hospitals, and 18.1% died within one year.