Survival of patients discharged to long term care.

Data on the life expectancy of elderly people in long term care facilities will be important for effective service planning and monitoring quality of care. To date there are no such data from an Irish perspective. A random sample of patients discharged to long term care between Jan 1st 1997 and December 31st 2003 from a single Dublin hospital was studied. Death by January 1st 2005 was ascertained through the register of births deaths and marriage. Median survival was calculated and factors associated with mortality were determined in a logistic regression. Mean (sd) age was 82 (11) years and 61 (29%) were female. Median survival was 30.3 (95%CI 22.4-45.0) months (mean Irish life expectancy at this age is about 78 months). Three factors were independently associated with death by 2 years: age (Odds ratio 1.11 [95%CI 1.05-1.17, F ratio 15.1, p=0.0001] per year), male gender (Odds ratio 1.52 [95%CI 1.05-3.68, F ratio 5.2, p=0.024]) and discharge to continuing care (Odds ratio 1.96 [1.05-3.68, F ratio 4.4, p=0.037]). These results (which are the first such Irish data) show that patients discharged to long term care are a frail group with a reduced life expectancy. Encouragingly survival for this cohort (25% at 1 year) was similar to that seen in other countries. Data on nursing home survival will allow more accurate planning of long term residential services and help monitor quality of care.