Three different outcomes in older community-dwelling patients receiving intermediate care in nursing home after acute hospitalization

Objectives To evaluate the recovery and outcome of older communitydwelling patients admitted to intermediate care (IC) in nursing homes after acute hospitalization, and to compare patients who were able and unable to return directly to their own homes. Design Prospective, observational, cohort study...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of nutrition, health & aging health & aging, 2016-04, Vol.20 (4), p.446-452
Main Authors: Abrahamsen, Jenny Foss, Haugland, C., Nilsen, R. M., Ranhoff, A. H.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aging
Cognitive ability
Cohort analysis
Delirium
Dementia
Geriatric Assessment
Geriatrics
Geriatrics/Gerontology
Home Care Services
Hospital Departments
Hospital Units
Hospitalization
Hospitalization - statistics & numerical data
Hospitals
Humans
Intermediate Care Facilities
Length of Stay
Medicine
Medicine & Public Health
Mortality
Neurosciences
Nursing care
Nursing Homes
Nutrition
Older people
Orthopedics
Patient Discharge
Patients
Physical therapy
Primary Care Medicine
Prospective Studies
Quality of Life Research
Subacute care
Time Factors
Treatment Outcome
Workforce planning
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objectives To evaluate the recovery and outcome of older communitydwelling patients admitted to intermediate care (IC) in nursing homes after acute hospitalization, and to compare patients who were able and unable to return directly to their own homes. Design Prospective, observational, cohort study conducted between June 2011 and 2014. Setting A 19- bed IC unit in a nursing home with increased multidisciplinary staffing. Participants A total of 961 community-dwelling patients, ≥70 years of age, considered to have a rehabilitation potential and no major cognitive impairment or delirium, transferred from internal medicine, cardiac, pulmonary and orthopaedic hospital departments. Measurements Demographic data, clinical information, comprehensive geriatric assessment (CGA), discharge destination and length of stay. Residence status and mortality 1 month, 2 months, 3 months, and 6 months after discharge from the hospital. Results The trajectory of recovery was divided into 3 groups: 1) Rapid recovery, able to return home after median 14 days in IC (n=785, 82%); 2) Slow recovery, requiring additional transfer to other nursing home after IC, but still able to return home within 2 months (n=106, 11%). 3) Poor recovery, requiring transfer to other nursing home after IC and still in a nursing home or dead at 2 months (n=66, 7%). Significant different clinical characteristics were demonstrated between the patients in the 3 groups. After 6 months, the recovery of patients with rapid or slow recovery was similar, 87% were living at home, compared to only 20% of the patients with poor recovery. In multiple logistic regression analysis, slow or poor recovery was significantly associated with low scores on the Barthel index and orthopaedic admission diagnosis. Conclusions Although the majority of patients selected for treatment in the IC unit were able to recover and return home, a group of patients needed extra time, up to 2 months, to recover and another group had a poor chance of recovering and returning home. Different caring pathways for different patient groups may be considered in the PAC setting.
ISSN:1279-7707
1760-4788
DOI:10.1007/s12603-015-0592-y