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Differences between nursing home admissions and residents
J Garrard1, J L Buchanan, E R Ratner
1Institute for Health Services Research, School of Public Health, University of Minnesota, Minneapolis.
Journal of Gerontology
|November 1, 1993
Summary
Nursing home admissions, unlike current residents, show greater dependency and higher service needs. Admissions are more likely to be discharged to the community but have similar mortality rates.
Area of Science:
- Gerontology
- Health Services Research
- Nursing Home Care
Background:
- Estimating nursing home admission characteristics using current resident data may introduce bias.
- Understanding the distinct profiles of admissions versus long-term residents is crucial for accurate healthcare planning.
Purpose of the Study:
- To compare the characteristics, service utilization, and outcomes of nursing home admissions versus current residents.
- To address the potential bias in using cross-sectional resident samples for admission characteristic estimation.
Main Methods:
- A comparative study analyzing abstracted records from an admissions cohort (n=1,118) and a residents cohort (n=830) within the same nursing homes.
- Analysis focused on functional dependency, clinical services, medication use, discharge destinations, mortality rates, and healthcare expenditures.
Main Results:
- Admissions exhibited significantly higher dependency in mobility and self-care, greater clinical service use, and increased medication rates compared to residents.
- Over 12 months, admissions had a fivefold higher likelihood of community discharge but similar mortality rates to residents.
- Both discharged and deceased individuals within each cohort incurred nearly double the expenditures of those remaining in the nursing home.
Conclusions:
- Nursing home admissions represent a distinct population with higher acuity and different trajectories than the general resident population.
- Accurate characterization of admissions is vital for appropriate resource allocation and care planning in long-term care settings.
- Higher expenditures are associated with transitions out of the nursing home, whether to the community or through mortality.