Discharge planning in nursing homes.


OBJECTIVE. The purpose of this study is to identify nursing home residents who vary in their discharge planning needs. DATA SOURCES AND STUDY SETTING. Administrative records from a database maintained by the National Health Corporation were the primary data source. The 3,883 persons studied were admitted in 1982 to one of 48 nursing homes located in Tennessee, other southern states, and Missouri. STUDY DESIGN. Residents were followed until discharge or for one year, whichever occurred first. A multinomial logistic regression model was used to identify the characteristics at the time of admission of persons likely to go home and the characteristics of those who may be able to be discharged to other residential care facilities. DATA EXTRACTION METHODS. A data tape with resident information was supplied by the National Health Corporation, which also provided data on the 48 nursing homes. Market data were obtained from the Area Resource File. PRINCIPAL FINDINGS. Health status measures are important predictors of discharge status. Financial status (i.e., primary payer) also had a large effect on discharge status; a measure of potential informal care in the community did not. CONCLUSIONS. It is possible to identify at admission nursing home residents likely to have very different discharge planning needs. Nursing home staff can use the results to focus their discharge planning efforts. Regulators can use them to assess how well nursing homes are meeting the discharge planning needs of their residents.

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