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Effect of Forced Transitions on the Most Functionally Impaired Nursing Home Residents
Author(s) -
Thomas Kali S.,
Dosa David,
Hyer Kathryn,
Brown Lisa M.,
Swaminathan Shailender,
Feng Zhanlian,
Mor Vincent
Publication year - 2012
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2012.04146.x
Subject(s) - medicine , nursing homes , retrospective cohort study , cohort , mortality rate , gerontology , emergency medicine , demography , nursing , sociology
Objectives To examine the hospitalization rate and mortality associated with forced mass transfer of nursing home ( NH ) residents with the highest levels of functional impairment. Design Retrospective cohort study. Setting One hundred nineteen T exas and L ouisiana NH s identified as being at risk for evacuation for H urricane G ustav. Participants Six thousand four hundred sixty‐four long‐stay residents residing in at‐risk NH s for at least three consecutive months before landfall of H urricane G ustav. Measurements Using M edicare claims and instrumental variable analysis, the mortality (death at 30 and 90 days) and hospitalization rates (at 30 and 90 days) of the most functionally impaired long‐stay residents who were evacuated for H urricane G ustav were compared with those of the most functionally impaired residents who did not evacuate. Results The effect of evacuation was associated with 8% more hospitalizations by 30 and 90 days for the most functionally impaired residents. Evacuation was not significantly related to mortality. Conclusion The most functionally impaired NH residents experience more hospitalizations but not mortality as a consequence of forced mass transfer. With the inevitability of NH evacuations for many different reasons, harm mitigation strategies focused on the most impaired residents are needed.