Kelman H R, Thomas C
Department of Epidemiology and Social Medicine, Montefiore Medical Center, Bronx, NY.
J Community Health. 1990 Apr;15(2):105-22. doi: 10.1007/BF01321315.
Over the course of a three year observation and study period, some 6% of a representative community residing urban elderly population were admitted to nursing homes. Nearly half of this group were still living in nursing homes at the end of this observation period. One third had died after entering the nursing home, and the remaining people had returned to their own homes in the community. These three groups had significantly different mean lengths of stay in nursing homes; nearly two years for those whose stays were more permanent, 50 days for those whose stays were short-term, and 153 days on average for those who died following admission. At baseline, the three groups also tended to have different patterns of health, functional and social characteristics. The short term stayers and those who died following admission to a nursing home differed from respondents who did not enter nursing homes--primarily in terms of prior living arrangements and levels of social support. The permanent stayers differed from the two other nursing home sub-groups, and from community residents, in that they tended to be older and more functionally and mentally impaired. However, at baseline they appeared at less risk to expire than those people who later died following admission to nursing homes. Clinical and research implications based on these findings are discussed.
在为期三年的观察和研究期间，一个具有代表性的城市老年社区居民中约6%的人住进了养老院。在观察期结束时，这一群体中近一半的人仍住在养老院。三分之一的人在进入养老院后死亡，其余的人回到了社区自己的家中。这三组人在养老院的平均住院时间有显著差异；长期居住者将近两年，短期居住者50天，入院后死亡者平均153天。在基线时，这三组人的健康、功能和社会特征模式也往往不同。短期居住者和入院后死亡者与未进入养老院的受访者不同——主要体现在先前的居住安排和社会支持水平方面。长期居住者与其他两个养老院亚组以及社区居民不同，因为他们往往年龄更大，功能和精神受损更严重。然而，在基线时，他们似乎比后来入院后死亡的人死亡风险更低。基于这些发现的临床和研究意义将进行讨论。
