[Factors influencing admission to nursing homes among frail and bedridden elderly persons receiving public health and welfare services].

A prospective study was conducted to elucidate the factors influencing admission to nursing homes among frail and bedridden elderly persons. The subjects were 149 persons, 70 years of age and above, who were living in Goshiki-cho, Hyogo prefecture and were receiving services from public health and welfare organizations. All of the subjects had a family physician and their own residence or own room at home. A follow-up study of admissions to nursing homes was performed from 1991 to 1996. The main results were as follows: 1. During the study (about 5 years), 42.9% (N = 64) of subjects were staying at home, 38.9% (N = 58) died at home, and 16.8% (N = 25) were admitted to nursing homes. 2. To find factors influencing admission to nursing homes, an analysis using Cox proportional, hazard model was conducted. Major factors found were high age, women, disabilities of hearing and eyesight, and difficulty in communication. The admission rate to nursing homes was especially high among patients 90 years of age or greater. 3. The admission rate to nursing homes was higher in subjects receiving home help services compared to the rest of the group. 4. Remarkable differences in household composition were observed between those who continued to stay at home and those admitted to nursing homes. Among the subjects living alone or living with a spouse, the mean age was significantly higher in the group who were admitted to nursing homes than those staying at home. In the case of two or three-generation households, the admission rate to nursing homes was high when the household lacked caregivers.