Acute hospitalization in a home for the aged.

All acute hospitalizations from a 229-bed home for the aged for a four-year period were analyzed. Of 373 residents eligible for the study, 239 individuals were hospitalized a total of 503 times. Five patients were admitted seven times. Median length of stay was 9.4 days. Of 235 primary diagnoses, only nine occurred at least 1% of the time. Sixty-six different complications, representing 131 occurrences, were noted during hospitalization. Hospital mortality was 11.7%. Of first admissions 9.2% died and 19% of survivors required a higher level of care. One year later 40% had died and 17% were at a higher level of care. Logistic regression identified four variables significantly associated with death within six months of first hospitalization: age, hospital complication, surgical procedure, and diagnosis of acute myocardial infarction. Compared with nonhospitalized residents, hospitalized residents were more likely to be male, but no age effect was noted. Survival differences did not emerge until the third year of the study.