Elaine Hubbard Center for Nursing Research on Aging, University of Rochester School of Nursing, Rochester, New York, USA.
Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA.
J Am Geriatr Soc. 2023 Nov;71(11):3480-3488. doi: 10.1111/jgs.18503. Epub 2023 Jul 14.
Despite the rapid growth of assisted living (AL) communities and the increasing similarity between AL and nursing home (NH) populations, little is known about the characteristics of older adults at the time of AL admission and how these characteristics compare to individuals newly admitted to NH from the community. This study examined the individual, facility, and geographic factors associated with new AL admission.
This retrospective descriptive study used data from the national Medicare enrollment and claims datasets, the Minimum Data Set, and the Medicare Provider Analysis and Review. The study cohort included 158,124 Medicare beneficiaries newly admitted to ALs and 715,261 newly admitted to NHs during 10/2017-10/2019. Multinomial logistic regression analysis and logistic regression analysis were conducted to examine factors associated with new admissions.
Demographic, socioeconomic, and health service use characteristics were associated with new admission to long-term care. Specifically, Medicare fee-for-service beneficiaries, those age 75 years and older, male, having one skilled nursing facility (SNF) stay or any hospital stay in the past 6 months are more likely to be newly admitted to AL, whereas those who are dually eligible, racial/ethnic minorities, and having two or more SNF stays in the past 6 months are more likely to be admitted to an NH.
There are substantial differences between individuals who are newly admitted from the community to AL versus those to NH.
尽管辅助生活（AL）社区迅速发展，AL 居民和养老院（NH）居民之间的相似性也越来越高，但人们对 AL 入院时老年人的特征知之甚少，也不知道这些特征与新从社区入院的 NH 患者有何不同。本研究调查了与新入住 AL 相关的个体、设施和地理因素。
本回顾性描述性研究使用了来自全国医疗保险登记和索赔数据集、最低数据集和医疗保险提供者分析和审查的数据。研究队列包括 2017 年 10 月至 2019 年 10 月期间新入住 AL 和新入住 NH 的 158124 名医疗保险受益人。采用多项逻辑回归分析和逻辑回归分析来检验与新入住相关的因素。
人口统计学、社会经济和卫生服务使用特征与长期护理的新入住有关。具体来说，医疗保险按服务收费的受益人、75 岁及以上的人、男性、过去 6 个月有一次熟练护理设施（SNF）入住或任何住院经历的人更有可能新入住 AL，而那些双重资格的人、少数民族、过去 6 个月有两次或更多次 SNF 入住经历的人更有可能入住 NH。
从社区新入住 AL 和 NH 的个体之间存在显著差异。
