This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Aditya, B S Articles by Vassallo, M Search for Related Content PubMed PubMed Citation Articles by Aditya, B S Articles by Vassallo, M Pubmed/NCBI databases Medline Plus Health Information Nursing Homes Social Bookmarking                         What's this?

Predictors of a nursing home placement from a non-acute geriatric hospital

J C Sharma

Ashfield Community Hospital, Portland Street, Kirkby-in-Ashfield, Bournemouth, UK

S C Allen

M Vassallo

Royal Bournemouth Hospital, Castle Lane East, Bournemouth BH7 7DW, UK michael.vassallo{at}rbch-tr.swest.nhs.uk

Background: Identifying patients who need Nursing Home (NH) care following a hospital admission is important.

Objective: To identify the factors that predispose to an NH discharge.

Design: Prospective observational study with blinded end-point evaluation.

Setting: A non-acute geriatric hospital.

Subjects: Two hundred consecutive elderly patients who were admitted for rehabilitation following treatment for an acute illness.

Main outcome measures: Discharge to an NH or home.

Results: Thirty-five out of the 150 live discharges (23.3%) were to an NH. NH discharges had a longer length of stay (38.5 versus 19.8 days; p < 0001). They were more likely to have visual impairment (p = 0.0009), confusion (p < 0.0001), wandering behaviour (p = 0.003), incontinence (p < 0.0001 or unsafe gait (p = 0.0005), to be on tranquillizers (p = 0.003), to be at risk of falls (p = 0.02) and to have sustained a fall while in hospital (p = 0.001). Multiple logistic regression identified confusion (p = 0.001), incontinence (p = 0.02), falls in hospital (p = 0.01), gait abnormalities (p < 0.001), tranquillizers (p < 0.001), impaired distant vision (p = 0.01) and living alone (p < 0.001) as independently associated with the risk of an NH discharge. This risk proportionately increased with the number of risk factors present: 4.28% for 0–2 factors, 25.8% for 3–4 factors and 81.8% for 5–6 factors (p < 0.0001).

Conclusion: These factors should be the target of specific rehabilitation in an attempt to reduce the risk of discharge to a nursing home and improve patient outcome.

Clinical Rehabilitation, Vol. 17, No. 1, 108-113 (2003)
DOI: 10.1191/0269215503cr567oa


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				R. Gilbert, C. Todd, M. May, L. Yardley, and Y. Ben-Shlomo Socio-demographic factors predict the likelihood of not returning home after hospital admission following a fall J. Public Health Med., August 7, 2009; (2009) fdp077v1. [Abstract] [Full Text] [PDF]