Factors associated with six-month mortality in recipients of community-based long-term care.

OBJECTIVES

To determine factors associated with short-term mortality in recipients of community-based long-term care (CBLTC).

DESIGN

A cohort study.

SETTING

A Medicaid home- and community-based waiver and state-funded homecare program.

PARTICIPANTS

All persons age 65 and older newly admitted to the program from January 1, 1988, to March 31, 1991.

MEASUREMENTS

Demographics, functional, cognitive, and health status, depression, and social support were obtained in an admission assessment. Six-month mortality data were obtained by linking assessment data to a state mortality registry.

RESULTS

There were 718 deaths among 6784 CBLTC clients. Male sex (AOR 1.8, 95% CI 1.5-2.1), the presence of cancer (AOR 3.2, CI 2.6-3.9), heart disease (AOR 1.3, CI 1.1-1.5), chronic obstructive pulmonary disease (AOR 1.8, CI 1.4-2.2), or nutritional problems (AOR 1.7, CI 1.4-2.0), functional impairment (AOR for lowest compared to highest quartile 2.9, CI 2.0-4.1), severe cognitive impairment (AOR 1.6, CI 1.3-2.1), self-assessment of health as poor (AOR 1.5, CI 1.1-2.0), feeling depressed (AOR 1.2, CI 1.1-1.3), and hospitalization (AOR 2.7, CI 2.2-3.2) were independently associated with 6-month mortality in bivariate and multivariate analyses.

CONCLUSIONS

Clinical data obtained during routine assessment of CBLTC clients can be used to assess short-term mortality. Six-month mortality is associated with poor functional and cognitive status, the presence of cancer, heart disease, COPD, and nutritional problems, depression, perception of poor health, and hospitalization.