OBJECTIVE: To explore what nursing home resident demographic, clinical, functional, and health services utilization characteristics influence a "do not hospitalize" designation. DESIGN: Historical cohort study. SETTING: Vancouver, BC. PARTICIPANTS: Extended care residents in 2 hospital-based and 4 free-standing nursing homes who died between 2001 and 2007. MAIN OUTCOME MEASURES: The designation of "do not hospitalize" on a resident's chart. RESULTS: Continuity of family physician care from admission to death (adjusted hazard ratio [AHR] 2.16, 95% confidence interval [CI] 1.33 to 3.49), a sudden and unexpected death (AHR 0.43, 95% CI 0.25 to 0.73), and age (AHR 1.02, 95% CI 1.01 to 1.02) were independently associated with a "do not hospitalize" designation. CONCLUSION: The greater than 2-fold positive association of continuity of family physician care with a "do not hospitalize" designation is an interesting addition to the literature on how continuity of physician care matters.
OBJECTIVE: To explore what nursing home resident demographic, clinical, functional, and health services utilization characteristics influence a "do not hospitalize" designation. DESIGN: Historical cohort study. SETTING: Vancouver, BC. PARTICIPANTS: Extended care residents in 2 hospital-based and 4 free-standing nursing homes who died between 2001 and 2007. MAIN OUTCOME MEASURES: The designation of "do not hospitalize" on a resident's chart. RESULTS: Continuity of family physician care from admission to death (adjusted hazard ratio [AHR] 2.16, 95% confidence interval [CI] 1.33 to 3.49), a sudden and unexpected death (AHR 0.43, 95% CI 0.25 to 0.73), and age (AHR 1.02, 95% CI 1.01 to 1.02) were independently associated with a "do not hospitalize" designation. CONCLUSION: The greater than 2-fold positive association of continuity of family physician care with a "do not hospitalize" designation is an interesting addition to the literature on how continuity of physician care matters.
Authors: D W Molloy; G H Guyatt; R Russo; R Goeree; B J O'Brien; M Bédard; A Willan; J Watson; C Patterson; C Harrison; T Standish; D Strang; P J Darzins; S Smith; S Dubois Journal: JAMA Date: 2000-03-15 Impact factor: 56.272
Authors: Daren K Heyland; Peter Dodek; Graeme Rocker; Dianne Groll; Amiram Gafni; Deb Pichora; Sam Shortt; Joan Tranmer; Neil Lazar; Jim Kutsogiannis; Miu Lam Journal: CMAJ Date: 2006-02-28 Impact factor: 8.262
Authors: Margaret J McGregor; Robert B Tate; Kimberlyn M McGrail; Lisa A Ronald; Anne-Marie Broemeling; Marcy Cohen Journal: Med Care Date: 2006-10 Impact factor: 2.983