Correlates of pressure sores in nursing homes: evidence from the National Medical Expenditure Survey.

Pressure sores are a serious medical problem that is most commonly found in nursing homes and hospitals. Most sores can be prevented. To prevent pressure sores in nursing homes through intervention, it is first necessary to identify factors associated with sore formation. Factors associated with the formation of pressure sores relate to skin susceptibility combined with the presence of moisture, constant pressure, and shear force or friction on the skin. This paper is the first to study the correlates of pressure sores for a nationally representative sample of nursing home residents. The paper estimates the relative contribution of resident health characteristics to the probability of having had a pressure sore during a nursing home stay for a cross-sectional sample of residents. Data are from 699 facilities and 2803 residents in nursing homes included in the 1987 Institutional Population Component of the National Medical Expenditure Survey. The principal caregiver in the facility was asked if "during the current stay" the resident had a "bed sore (decubitus ulcer)." Findings indicate that having diagnoses of Parkinson's disease, diabetes, or paraplegia, being underweight, older, male, unable to walk, needing help feeding or unable to feed, having frequent fecal and urinary incontinence accidents, and being admitted from a hospital increase the likelihood of having had a pressure sore during the stay. Cognitively impaired residents who could feed themselves independently or with help were less likely to have had a sore, but cognitively impaired residents who were unable to feed themselves at all were at more risk than cognitively intact residents.