Targeting Residents for Transitions from Nursing Home to Community

Authors

  • Greg Arling,

    1. Indiana University Center for Aging Research, Regenstrief Institute, Health Information and Translational Sciences Building, 410 West 10th Street, Suite 2000, Indianapolis, IN 46202-3012
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    • Address correspondence to Greg Arling, Ph.D., Associate Professor of Medicine & Scientist, Indiana University Center for Aging Research, Regenstrief Institute, Health Information and Translational Sciences Building, 410 West 10th Street, Suite 2000, Indianapolis, IN 46202-3012; e-mail: garling@iupui.edu. Robert L. Kane, M.D., is with the Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, MN. Valerie Cooke, B.A., B.S., and Teresa Lewis, B.A., are with the Minnesota Department of Human Services, Nursing Facility Rates and Policy Division, St. Paul, MN.

  • Robert L. Kane,

    1. Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, MN
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  • Valerie Cooke,

    1. Minnesota Department of Human Services, Nursing Facility Rates and Policy Division, St. Paul, MN
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  • Teresa Lewis

    1. Minnesota Department of Human Services, Nursing Facility Rates and Policy Division, St. Paul, MN
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Abstract

Objective. To analyze nursing home utilization patterns in order to identify potential targeting criteria for transitioning residents back to the community.

Data Sources. Secondary data from minimum data set (MDS) assessments for an annual cohort of first-time admissions (N=24,648) to all Minnesota nursing homes (N=394) from July 2005 to June 2006.

Study Design. We conducted a longitudinal analysis from admission to 365 days. Major MDS variables were discharge status; resident's preference and support for community discharge; gender, age, and marital status; pay source; major diagnoses; cognitive impairment or dementia; activities of daily living; and continence.

Principal Findings. At 90 days the majority of residents showed a preference or support for community discharge (64 percent). Many had health and functional conditions predictive of community discharge (40 percent) or low-care requirements (20 percent). A supportive facility context, for example, emphasis on postacute care and consumer choice, increased transition rates.

Conclusions. A community discharge intervention could be targeted to residents at 90 days after nursing home admission when short-stay residents are at risk of becoming long-stay residents.

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