A Longitudinal Analysis of Functional Disability, Recovery, and Nursing Home Utilization After Hospitalization for Ambulatory Care Sensitive Conditions Among Community-Living Older Persons
| Autor: | Linda Leo-Summers, Cameron J. Gettel, Thomas M. Gill, Terrence E. Murphy, Ula Hwang, Evelyne A. Gahbauer, Arjun K. Venkatesh |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Leadership and Management Aftercare Assessment and Diagnosis 03 medical and health sciences 0302 clinical medicine Ambulatory care Community living Ambulatory Care medicine Humans 030212 general & internal medicine Care Planning Original Research Aged Aged 80 and over business.industry 030503 health policy & services Health Policy Total disability Mean age General Medicine Functional recovery Patient Discharge Nursing Homes Hospitalization Functional disability Cohort Physical therapy Fundamentals and skills 0305 other medical science Nursing homes business |
| Zdroj: | J Hosp Med |
| ISSN: | 1553-5606 1553-5592 |
| Popis: | BACKGROUND/OBJECTIVE: Hospitalizations for ambulatory care sensitive conditions (ACSCs) are considered potentially preventable. With little known about the functional outcomes of older persons after ACSC-related hospitalizations, our objectives were to describe: (1) the 6-month course of postdischarge functional disability, (2) the cumulative monthly probability of functional recovery, and (3) the cumulative monthly probability of incident nursing home (NH) admission. METHODS: The analytic sample included 251 ACSC-related hospitalizations from a cohort of 754 nondisabled, community-living persons aged 70 years and older who were interviewed monthly for up to 19 years. Patient-reported disability scores in basic, instrumental, and mobility activities ranged from 0 to 13. Functional recovery was defined as returning within 6 months of discharge to a total disability score less than or equal to that immediately preceding hospitalization. RESULTS: The mean age was 85.1 years, and the mean disability score was 5.4 in the month prior to the ACSC-related hospitalization. After the ACSC-related hospitalization, total disability scores peaked at month 1 and improved modestly over the next 5 months, but remained greater than the pre-hospitalization score. Functional recovery was achieved by 70% of patients, and incident NH admission was experienced by 50% within 6 months after the 251 ACSC-related hospitalizations. CONCLUSIONS: During the 6 months after an ACSC-related hospitalization, older persons exhibited total disability scores that were higher than those immediately preceding hospitalization, with 3 of 10 not achieving functional recovery and half experiencing incident NH admission. These findings provide evidence that older persons experience clinically meaningful adverse patient-reported outcomes after ACSC-related hospitalizations. |
| Databáze: | OpenAIRE |
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