Frailty and Time at Home After Post-Acute Care in Skilled Nursing Facilities.
Frailty
post-acute care
skilled nursing facility
time at home
Journal
Journal of the American Medical Directors Association
ISSN: 1538-9375
Titre abrégé: J Am Med Dir Assoc
Pays: United States
ID NLM: 100893243
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
received:
27
12
2022
revised:
21
02
2023
accepted:
23
02
2023
pmc-release:
01
07
2024
medline:
26
6
2023
pubmed:
4
4
2023
entrez:
3
4
2023
Statut:
ppublish
Résumé
To examine the association of a claims-based frailty index with time at home, defined as the number of days alive and spent out of hospital or skilled nursing facility (SNF). Cohort Study. A 5% Medicare random sample of fee-for-service beneficiaries, who had continuous part A and B enrollment in the prior 6 months, that were discharged from a short SNF admission in 2014‒2016. Frailty was measured with a validated claims-based frailty index (CFI) (range: 0‒1, higher scores indicating worse frailty) and categorized into nonfrail (CFI <0.25), mild frailty (CFI 0.25‒0.34), and moderate-to-severe frailty (CFI ≥0.35). We measured home time in the 6 months following SNF discharge (range: 0‒182 days with higher values representing more days at home and thus a better outcome). We used logistic regression to assess the association between frailty and short home time, defined as <173 days, adjusting for age, sex, race, region, a comorbidity index, clinical SNF admission characteristics in the Minimum Data Set, and SNF characteristics. In our sample of 144,708 beneficiaries (mean age, 80.8 years, 64.9% female, 85.9% white) who were discharged to community after SNF stay, the mean CFI was 0.26 (standard deviation, 0.07). The mean home time was 165.6 (38.1) days in nonfrail, 154.4 (47.4) days in mild frailty, 145.0 (52.0) days in moderate-to-severe frailty group. After full model adjustments, moderate to severe frailty was associated with a 1.71 (95% CI 1.65‒1.78) higher odds of having short time at home in the 6 months following SNF discharge. Higher CFI is associated with short time at home in Medicare beneficiaries who are discharged to the community after post-acute SNF stay. Our results support the utility of CFI in identifying SNF patients who need additional resources and interventions to prevent health decline and poor quality of life.
Identifiants
pubmed: 37011886
pii: S1525-8610(23)00229-3
doi: 10.1016/j.jamda.2023.02.106
pmc: PMC10293028
mid: NIHMS1881295
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
997-1001.e2Subventions
Organisme : NIA NIH HHS
ID : K24 AG073527
Pays : United States
Organisme : NIA NIH HHS
ID : L30 AG069162
Pays : United States
Organisme : NIA NIH HHS
ID : R03 AG078894
Pays : United States
Informations de copyright
Copyright © 2023 AMDA – The Society for Post-Acute and Long-Term Care Medicine. All rights reserved.
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