ArticleJournal of the American Medical Directors Association2025
Care Trajectories for a Cohort of First-Time Nursing Home Admissions: A 5-Year Longitudinal Study in Minnesota.
Article in Journal of the American Medical Directors Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThis study modeled 5-year care trajectories of first-time, dual-eligible older adults admitted to Minnesota nursing homes (NHs), capturing discharges to the community, NH readmissions, hospitalizations, and mortality. A secondary aim was to examine associations between care trajectories and dementia, baseline cognitive function, and demographic, clinical, and functional profiles.
designRetrospective cohort study. SETTING AND
participantsWe analyzed 9853 older adults first admitted to Minnesota NHs in 2015 and followed them for up to 60 months. Minimum Data Set were linked to Medicaid claims from the Minnesota Medicaid Management Information System.
methodsLatent class growth analysis identified trajectories based on monthly NH stay, hospitalization, and community stay, with mortality treated as a discrete time survival outcome. Dementia was included as a binary covariate. Resident characteristics across trajectories were compared using bivariate analyses and multinomial logistic regression.
resultsThe following 4 distinct trajectories were identified: (1) trajectory 1 (early mortality with continued NH use, 38%) experienced shortest survival, highest NH utilization, and peak hospitalizations in year 1; (2) trajectory 2 (steady return to long-term NH care, 11%) had longer survival and frequent hospitalizations in years 2 and 3, ultimately spending 90% of time alive in NHs by year 5; (3) trajectory 3 (transitional care with multiple moves, 22%) had better survival and longer community stays but the most transitions, with increased NH use over time; and (4) trajectory 4 (short stay then return to community, 29%) experienced best outcomes with longest survival, minimal NH readmissions, and few hospitalizations. Trajectories were significantly associated with baseline differences in cognitive function, physical dependency, and sociodemographic characteristics. CONCLUSIONS AND IMPLICATIONS: Care trajectories among dual-eligible NH residents are highly heterogeneous. Although 38% remained in NHs until death, 29% sustained community living, and 33% experienced frequent transitions. These patterns underscore the need for individualized care planning and system-level strategies to meet complex, evolving needs.
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