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Impact of long term care and mortality risk in community care and nursing homes populations

Lopes, Hugo and Mateus, Céu and Rosati, Nicoletta (2018) Impact of long term care and mortality risk in community care and nursing homes populations. Archives of Gerontology and Geriatrics, 76. pp. 160-168. ISSN 0167-4943

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    Abstract

    Objectives To identify the survival time, the mortality risk factors and the individuals’ characteristics associated with cognitive and physical status at discharge, among the Portuguese long-term care (LTC) populations. Settings Home-and-Community-Based Services (HCBS) and three types of nursing home (NH). Participants 20,984 individuals admitted and discharged in 2015. Measurements The Kaplan-Meier survival analysis and the Cox Proportional Hazards Models were used to study the mortality risk; the Wilcoxon signed-rank test to identify the number of individuals with cognitive and physical changes between admission and discharge; two cumulative odds ordinal logistic regressions to predict the cognitive and physical dependence levels at discharge Results The mortality rate at HCBS was 30%, and 17% at the NH, with a median survival time of 173 and 200 days, respectively. The main factors associated with higher mortality were older age, male gender, family/neighbour support, neoplasms and cognitive/physical dependence at admission. In NH/HCBS, 26%/18% of individuals improve their cognitive status, while in physical status, the proportion was 38%/27%, respectively. Finally, older age, being illiterate and being classified at the lowest cognitive and physical status at admission decrease the likelihood of achieving a higher level of cognitive and physical independence at discharge. Conclusions The adoption of a robust and complete assessment tool, the definition of guidelines to enable a periodical assessment of individuals’ autonomy and the adoption of benchmark metrics allowing the comparison of results between similar units are some of the main goals to be taken into account for future developments of this care in Portugal.

    Item Type: Journal Article
    Journal or Publication Title: Archives of Gerontology and Geriatrics
    Additional Information: This is the author’s version of a work that was accepted for publication in Archives of Gerontology and Geriatrics. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Archives of Gerontology and Geriatrics, 76, 2018 DOI: 10.1016/j.archger.2018.02.009
    Uncontrolled Keywords: Nursing Homes ; Home and Community-Based Services ; Mortality risk ; Outcomes assessment ; Portugal
    Subjects:
    Departments: Faculty of Health and Medicine > Health Research
    ID Code: 123892
    Deposited By: ep_importer_pure
    Deposited On: 08 Mar 2018 10:06
    Refereed?: Yes
    Published?: Published
    Last Modified: 15 Oct 2018 16:52
    Identification Number:
    URI: http://eprints.lancs.ac.uk/id/eprint/123892

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