Open AccessDepression and Nursing Home Admission Among Hospitalized Older Adults With Coronary Artery Disease: A Propensity Score Analysis
Author(s) -
Ahmed Ali,
Lefante Christina M.,
Alam Nazmul
Publication year - 2007
Publication title -
the american journal of geriatric cardiology
Language(s) - English
Resource type - Journals
eISSN - 1751-715X
pISSN - 1076-7460
DOI - 10.1111/j.1076-7460.2007.05519.x
Subject(s) - medicine , confidence interval , depression (economics) , logistic regression , propensity score matching , coronary artery disease , ambulatory , relative risk , emergency medicine , economics , macroeconomics
Admission to a nursing home is considered a poor outcome for community‐dwelling older adults. The objective of this study was to determine whether depression increased the risk of nursing home admission. Using the National Hospital Discharge Survey 2001–2003 datasets, the authors identified 28,172 community‐dwelling older adults, 65 years and older, discharged alive with a primary discharge diagnosis of coronary artery disease. The objective of this study was to determine the association between depression and subsequent nursing home admissions in these patients. Propensity scores for depression, calculated for each patient using a multivariable logistic regression model, were used to match 686 depressed patients with 2058 nondepressed patients who had similar propensity scores. Logistic regression analyses were used to determine the association between depression and nursing home admission. Patients had a mean age ± SD of 77±8 years, and 61% were women. Compared with 9% of nondepressed patients, 13% of depressed patients were admitted to nursing homes (relative risk, 1.42; 95% confidence interval, 1.12–1.78). When adjusted for various demographic, clinical, and care‐related covariates, the association became somewhat stronger (adjusted relative risk, 1.55; 95% confidence interval, 1.21–1.99). In ambulatory older adults hospitalized with coronary artery disease, a secondary diagnosis of depression was associated with a significantly increased risk of nursing home admission.