Phillips Charles D, Munoz Yolanda, Sherman Michael, Rose Miriam, Spector William, Hawes Catherine
Department of Health Policy and Management, School of Rural Public Health, Texas A & M University Health System Science Center, Bryan, 77802, USA.
Gerontologist. 2003 Oct;43(5):690-6. doi: 10.1093/geront/43.5.690.
Assisted living is an increasingly important residential setting for the frail elderly person. How often and why residents leave such facilities are important issues for consumers, for clinicians advising frail patients on their options for living arrangements, and for policymakers. This research investigated the impact of facility and individual characteristics on residents' departures from assisted living.
This research is based on data on 1,483 residents in a nationally representative sample of 278 assisted living facilities (ALFs). Analyses of these data from 1998 and 1999 especially focused on those residents who left a study ALF between baseline and follow-up data collection. Multinomial logit models were estimated to investigate the impact of facility and individual factors on residents' status at follow-up.
Over three quarters of those leaving their baseline ALF did so because they needed more care. The multivariate analyses indicated that poorer functional status and being married affected residents' relative odds of death before follow-up. Moving to another setting, other than a nursing home, was more likely for residents in for-profit ALFs. Functional status, cognitive status, and the presence of a full-time RN affected residents' odds of moving from an ALF to a nursing home.
Both facility-level and individual-level factors affected residents' relative odds of leaving an ALF. The findings with the most potentially interesting policy implications are those concerning the factors that affected residents' relative likelihoods of entering a nursing home.
辅助生活对体弱老年人来说是一种日益重要的居住模式。居民离开此类设施的频率及原因,对于消费者、为体弱患者提供居住安排建议的临床医生以及政策制定者而言,都是重要问题。本研究调查了设施特征和个人特征对辅助生活居民离开的影响。
本研究基于全国范围内278家辅助生活设施(ALF)的具有代表性的样本中1483名居民的数据。对1998年和1999年这些数据的分析特别关注那些在基线和随访数据收集期间离开研究ALF的居民。估计多项logit模型以调查设施因素和个人因素对随访时居民状态的影响。
超过四分之三离开其基线ALF的居民是因为他们需要更多护理。多变量分析表明,功能状态较差和已婚会影响居民在随访前死亡的相对概率。营利性ALF中的居民更有可能搬到除养老院之外的其他地方。功能状态、认知状态以及全职注册护士的配备会影响居民从ALF搬到养老院的概率。
设施层面和个人层面的因素都会影响居民离开ALF的相对概率。最具潜在有趣政策含义的研究结果是那些涉及影响居民进入养老院相对可能性的因素。