IMMEDIATE AND SUBSEQUENT OUTCOMES OF NURSING HOME CARE.
Contributors: University of California, Los Angeles.
Published: 1984
Number of pages: 240
Subjects: Health Sciences, Nursing.
Description: There is a paucity of information on the subsequent history of individuals admitted to nursing homes. Classification of patients as alive or dead on discharge provides only cross-sectional data of limited value to those concerned with policy issues such as cost-containment, and optimal re-imbursement strategies for nursing home care.

A retrospective study was conducted of 563 patients discharged from 24 nursing homes in Southern California during the calendar year, 1980. The patients were traced from admission through discharge to ascertain their living arrangements, use of health facilities and outcome status as of December 31, 1982. The nursing home record was the source of identifying patient characteristics, length of stay and discharge status. Letters and follow-up phone calls to health facilities, families, and friends were used to ascertain each resident's status and living arrangements immediately following discharge and two years later. Deaths were verified by search of County records. Data from the California Health Facility Commission were used to characterize the nursing homes.

Thirty percent of patients died in nursing homes, and 11 percent died within two weeks after transfer to hospitals. Twenty-five percent of patients transferred to general hospitals survived, and returned to nursing homes. Twenty-eight percent of patients returned home and 7 percent were transferred to nursing homes. Three patient characteristics--confusion, incontinence and dependence in Activities of Daily Living were significant predictors of outcome status at discharge and at two years. Five hundred and twenty-nine patients were traced for over a two year period. Of these, only 38 persons were alive at home; 36 of them had been initially discharged to their homes. Seventy-six percent of patients were dead at two years.

Analysis of a subset of 197 patients admitted to nursing homes for the first time identified four subgroups of patients with significantly different patterns of survival, and use of health care resources: 9.5 percent were discharged home and received no further institutional care during two years: 37 percent died in the nursing homes: the remaining 54 percent transferred frequently between hospitals and nursing homes with occasional periods at home.

The results illustrate the dynamic patient flow in and out of nursing homes, and the possibility of defining groups of patients with similar functional status, use of services and outcomes.
Notes: Source: Dissertation Abstracts International, Volume: 45-03, Section: B, page: 0829.

Thesis (PH.D.)--UNIVERSITY OF CALIFORNIA, LOS ANGELES, 1984.

School code: 0031.