Cari R Levy1, Farrokh Alemi2, Allison E Williams3, Arthur R Williams4, Janusz Wojtusiak5, Bryce Sutton4, Phan Giang5, Etienne Pracht6, Lisa Argyros3. 1. Department of Internal Medicine, Palliative Care, Veterans Affairs Medical Center Eastern Colorado Health Care System, Denver. 2. Department of Health Administration and Policy, George Mason University, Fairfax Virginia. Office of Chief of Staff, District of Columbia Veterans Affairs Medical Center, Washington DC. falemi@gmu.edu. 3. Bay Pines Veterans Administration Healthcare System, Florida. 4. Center of Innovation on Disability and Rehabilitation Research, James A Haley Veterans Administration Medical Center, Tampa, Florida. 5. Department of Health Administration and Policy, George Mason University, Fairfax Virginia. 6. Department of Health Administration and Policy, University of South Florida, Tampa.
Abstract
PURPOSE OF THE STUDY: This study compares hospitalization rates for common conditions in the Veteran Affairs (VA) Medical Foster Home (MFH) program to VA nursing homes, known as Community Living Centers (CLCs). DESIGN AND METHODS: We used a nested, matched, case control design. We examined 817 MFH residents and matched each to 3 CLC residents selected from a pool of 325,031. CLC and MFH cases were matched on (a) baseline time period, (b) follow-up time period, (c) age, (d) gender, (e) race, (f) risk of mortality calculated from comorbidities, and (g) history of hospitalization for the selected condition during the baseline period. Odds ratio (OR) and related confidence interval (CI) were calculated to contrast MFH cases and matched CLC controls. RESULTS: Compared with matched CLC cases, MFH residents were less likely to be hospitalized for adverse care events, (OR = 0.13, 95% CI = 0.03-0.53), anxiety disorders (OR = 0.52, 95% CI = 0.33-0.80), mood disorders (OR = 0.57, 95% CI = 0.42-0.79), skin infections (OR = 0.22, 95% CI = 0.10-0.51), pressure ulcers (OR = 0.22, 95% CI = 0.09-0.50) and bacterial infections other than tuberculosis or septicemia (OR = 0.54, 95% CI = 0.31-0.92). MFH cases and matched CLC controls did not differ in rates of urinary tract infections, pneumonia, septicemia, suicide/self-injury, falls, other injury besides falls, history of injury, delirium/dementia/cognitive impairments, or adverse drug events. Hospitalization rates were not higher for any conditions studied in the MFH cohort compared with the CLC cohort. IMPLICATIONS: MFH participants had the same or lower rates of hospitalizations for conditions examined compared with CLC controls suggesting that noninstitutional care by a nonfamilial caregiver does not increase hospitalization rates for common medical conditions. Published by Oxford University Press on behalf of the Gerontological Society of America 2015.
PURPOSE OF THE STUDY: This study compares hospitalization rates for common conditions in the Veteran Affairs (VA) Medical Foster Home (MFH) program to VA nursing homes, known as Community Living Centers (CLCs). DESIGN AND METHODS: We used a nested, matched, case control design. We examined 817 MFH residents and matched each to 3 CLC residents selected from a pool of 325,031. CLC and MFH cases were matched on (a) baseline time period, (b) follow-up time period, (c) age, (d) gender, (e) race, (f) risk of mortality calculated from comorbidities, and (g) history of hospitalization for the selected condition during the baseline period. Odds ratio (OR) and related confidence interval (CI) were calculated to contrast MFH cases and matched CLC controls. RESULTS: Compared with matched CLC cases, MFH residents were less likely to be hospitalized for adverse care events, (OR = 0.13, 95% CI = 0.03-0.53), anxiety disorders (OR = 0.52, 95% CI = 0.33-0.80), mood disorders (OR = 0.57, 95% CI = 0.42-0.79), skin infections (OR = 0.22, 95% CI = 0.10-0.51), pressure ulcers (OR = 0.22, 95% CI = 0.09-0.50) and bacterial infections other than tuberculosis or septicemia (OR = 0.54, 95% CI = 0.31-0.92). MFH cases and matched CLC controls did not differ in rates of urinary tract infections, pneumonia, septicemia, suicide/self-injury, falls, other injury besides falls, history of injury, delirium/dementia/cognitive impairments, or adverse drug events. Hospitalization rates were not higher for any conditions studied in the MFH cohort compared with the CLC cohort. IMPLICATIONS: MFH participants had the same or lower rates of hospitalizations for conditions examined compared with CLC controls suggesting that noninstitutional care by a nonfamilial caregiver does not increase hospitalization rates for common medical conditions. Published by Oxford University Press on behalf of the Gerontological Society of America 2015.
Entities:
Keywords:
Caregiving-formal; Caregiving-informal; Hospitalization; Matched case control evaluation; Nursing home care
Authors: Kali S Thomas; Danielle Cote; Rajesh Makineni; Orna Intrator; Bruce Kinosian; Ciaran S Phibbs; Susan M Allen Journal: J Aging Soc Policy Date: 2018-01-08
Authors: Janusz Wojtusiak; Negin Asadzadehzanjani; Cari Levy; Farrokh Alemi; Allison E Williams Journal: BMC Med Inform Decis Mak Date: 2021-01-09 Impact factor: 2.796