ArticleJournal of the American Geriatrics Society2017
Hospital Variation in Rates of New Institutionalizations Within 6 Months of Discharge.
Article in Journal of the American Geriatrics Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 7 citations in OpenAlex.
- Care patterns and predictors of community residence among older patients after hospital discharge for traumatic brain injury.Journal of the American Geriatrics Society · 2023Article
- Differences Between Skilled Nursing Facilities in Risk of Subsequent Long-Term Care Placement.Journal of the American Geriatrics Society · 2018Article
- Trajectories Over the First Year of Long-Term Care Nursing Home Residence.Journal of the American Medical Directors Association · 2018Article
- New Institutionalization in Long-Term Care After Hospital Discharge to Skilled Nursing Facility.Journal of the American Geriatrics Society · 2018Article
- TILE-12 index: an interpretable instrument for identifying older adults at risk for transitions in living environment within the next 12-months.Home health care services quarterlyArticle
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
objectivesHospitalization in community-dwelling elderly is often accompanied by functional loss, increasing the risk for continued functional decline and future institutionalization. The primary objective of our study was to examine the hospital-level variation in rates of new institutionalizations among Medicare beneficiaries.
designRetrospective cohort study.
settingHospitals and nursing homes.
participantsMedicare fee-for-service beneficiaries discharged from 4,469 hospitals in 2013 (N = 4,824,040). MEASUREMENTS: New institutionalization, defined as new long term care nursing home residence (not skilled nursing facility) of at least 90 days duration within 6 months of hospital discharge.
resultsThe overall observed rate of new institutionalizations was 3.6% (N = 173,998). Older age, white race, Medicaid eligibility, longer hospitalization, and having a skilled nursing facility stay over the 6 months before hospitalization were associated with higher adjusted odds. Observed rates ranged from 0.9% to 5.9% across states. The variation in rates attributable to the hospital after adjusting for case-mix and state was 5.1%. Odds were higher for patients treated in smaller (OR = 1.36, 95% CI: 1.27-1.45, ≤50 vs >500 beds), government owned (OR = 1.15, 95% CI: 1.09-1.21 compared to for-profit), limited medical school affiliation (OR = 1.13, 95% CI: 1.07-1.19 compared to major) hospitals and lower for patients treated in urban hospitals (OR = 0.79, 95% CI: 0.76-0.82 compared to rural). Higher Summary Star ratings (OR = 0.75, 95% CI: 0.67-0.93, five vs one stars) and Overall Hospital Rating (OR = 0.62, 95% CI: 0.57-0.67, ratings of 9-10 vs 0) were associated with lower odds of institutionalization.
conclusionHospitalization may be a critical period for preventing future institutionalization among elderly patients. The variation in rates across hospitals and its association with hospital quality ratings suggest some of these institutionalizations are avoidable and may represent targets for care improvement.
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