终末期居住在养老院的老年人的住院时间。
Length of stay for older adults residing in nursing homes at the end of life.
机构信息
Veterans Affairs Medical Center, San Francisco, California, USA.
出版信息
J Am Geriatr Soc. 2010 Sep;58(9):1701-6. doi: 10.1111/j.1532-5415.2010.03005.x. Epub 2010 Aug 24.
OBJECTIVES
To describe lengths of stay of nursing home decedents.
DESIGN
Retrospective cohort study.
SETTING
The Health and Retirement Study (HRS), a nationally representative survey of U.S. adults aged 50 and older.
PARTICIPANTS
One thousand eight hundred seventeen nursing home residents who died between 1992 and 2006.
MEASUREMENTS
The primary outcome was length of stay, defined as the number of months between nursing home admission and date of death. Covariates were demographic, social, and clinical factors drawn from the HRS interview conducted closest to the date of nursing home admission.
RESULTS
The mean age of decedents was 83.3 ± 9.0; 59.1% were female, and 81.5% were white. Median and mean length of stay before death were 5 months (interquartile range 1-20) and 13.7 ± 18.4 months, respectively. Fifty-three percent died within 6 months of placement. Large differences in median length of stay were observed according to sex (men, 3 months vs women, 8 months) and net worth (highest quartile, 3 months vs lowest quartile, 9 months) (all P <.001). These differences persisted after adjustment for age, sex, marital status, net worth, geographic region, and diagnosed chronic conditions (cancer, hypertension, diabetes mellitus, lung disease, heart disease, and stroke).
CONCLUSION
Nursing home lengths of stay are brief for the majority of decedents. Lengths of stay varied markedly according to factors related to social support.
目的
描述养老院死亡者的住院时间。
设计
回顾性队列研究。
地点
健康与退休研究（HRS），一项针对美国 50 岁及以上成年人的全国代表性调查。
参与者
1817 名 1992 年至 2006 年间在养老院去世的居民。
测量
主要结局是住院时间，定义为养老院入住和死亡日期之间的月数。协变量为 HRS 访谈中最接近养老院入住日期的人口统计学、社会和临床因素。
结果
死者的平均年龄为 83.3 ± 9.0；59.1%为女性，81.5%为白人。死亡前的中位数和平均住院时间分别为 5 个月（四分位距 1-20）和 13.7 ± 18.4 个月。53%的人在安置后 6 个月内死亡。根据性别（男性 3 个月，女性 8 个月）和净资产（最高四分位数 3 个月，最低四分位数 9 个月），中位数住院时间存在显著差异（均 P<.001）。在调整年龄、性别、婚姻状况、净资产、地理区域和诊断的慢性疾病（癌症、高血压、糖尿病、肺病、心脏病和中风）后，这些差异仍然存在。
结论
对于大多数死者来说，养老院的住院时间是短暂的。住院时间根据与社会支持相关的因素而有很大差异。
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