OBJECTIVES: To examine the hospitalization rate and mortality associated with forced mass transfer of nursing home (NH) residents with the highest levels of functional impairment. DESIGN: Retrospective cohort study. SETTING: One hundred nineteen Texas and Louisiana NHs identified as being at risk for evacuation for Hurricane Gustav. PARTICIPANTS: Six thousand four hundred sixty-four long-stay residents residing in at-risk NHs for at least three consecutive months before landfall of Hurricane Gustav. MEASUREMENTS: Using Medicare claims and instrumental variable analysis, the mortality (death at 30 and 90 days) and hospitalization rates (at 30 and 90 days) of the most functionally impaired long-stay residents who were evacuated for Hurricane Gustav were compared with those of the most functionally impaired residents who did not evacuate. RESULTS: The effect of evacuation was associated with 8% more hospitalizations by 30 and 90 days for the most functionally impaired residents. Evacuation was not significantly related to mortality. CONCLUSION: The most functionally impaired NH residents experience more hospitalizations but not mortality as a consequence of forced mass transfer. With the inevitability of NH evacuations for many different reasons, harm mitigation strategies focused on the most impaired residents are needed.
OBJECTIVES: To examine the hospitalization rate and mortality associated with forced mass transfer of nursing home (NH) residents with the highest levels of functional impairment. DESIGN: Retrospective cohort study. SETTING: One hundred nineteen Texas and Louisiana NHs identified as being at risk for evacuation for Hurricane Gustav. PARTICIPANTS: Six thousand four hundred sixty-four long-stay residents residing in at-risk NHs for at least three consecutive months before landfall of Hurricane Gustav. MEASUREMENTS: Using Medicare claims and instrumental variable analysis, the mortality (death at 30 and 90 days) and hospitalization rates (at 30 and 90 days) of the most functionally impaired long-stay residents who were evacuated for Hurricane Gustav were compared with those of the most functionally impaired residents who did not evacuate. RESULTS: The effect of evacuation was associated with 8% more hospitalizations by 30 and 90 days for the most functionally impaired residents. Evacuation was not significantly related to mortality. CONCLUSION: The most functionally impaired NH residents experience more hospitalizations but not mortality as a consequence of forced mass transfer. With the inevitability of NH evacuations for many different reasons, harm mitigation strategies focused on the most impaired residents are needed.
Authors: David Dosa; Kathryn Hyer; Kali Thomas; Shailender Swaminathan; Zhanlian Feng; Lisa Brown; Vincent Mor Journal: J Am Med Dir Assoc Date: 2011-08-31 Impact factor: 4.669
Authors: Julianne Skarha; Lily Gordon; Nazmus Sakib; Joseph June; Dylan J Jester; Lindsay J Peterson; Ross Andel; David M Dosa Journal: JAMA Health Forum Date: 2021-11-24
Authors: Lindsay J Peterson; Joseph June; Nazmus Sakib; Debra Dobbs; David M Dosa; Kali S Thomas; Dylan J Jester; Kathryn Hyer Journal: J Am Med Dir Assoc Date: 2020-03-07 Impact factor: 4.669
Authors: Dylan J Jester; Kali S Thomas; Lindsay J Peterson; David M Dosa; Ross Andel; Kathryn Hyer Journal: J Am Geriatr Soc Date: 2021-05-12 Impact factor: 7.538
Authors: David M Dosa; Julianne Skarha; Lindsay J Peterson; Dylan J Jester; Nazmus Sakib; Jessica Ogarek; Kali S Thomas; Ross Andel; Kathryn Hyer Journal: JAMA Netw Open Date: 2020-10-01