Trajectories of Functional Change Among Long Stayers in Nursing Homes: Does Baseline Impairment Matter?
Trajectories of Functional Change Among Long Stayers in Nursing Homes: Does Baseline Impairment Matter?
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DOI：
10.1177/0898264311399759
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发表时间：
2011-08-01
影响因子：
2.8
通讯作者：
Verbrugge, Lois M.
中科院分区：
文献类型：
--
作者：
Banaszak-Holl, Jane;Liang, Jersey;Verbrugge, Lois M.
目的：本研究通过检查基线医疗状况和功能状态对居民住院期间 (LOS) 期间身体损伤变化的影响，报告长期居民功能变化轨迹的发现。方法：使用 1999 年至 2003 年密歇根州疗养院居民的 5% 样本来创建纵向护理事件，包括最小数据集 (MDS) 评估。使用分层线性模型分析数据。结果：平均来说，身体损伤在居民入住期间会增加，并且在入住后期会更快。基线时较大的身体和认知障碍会导致居民的损伤增加，而基线健康状况（包括心脏病和髋部骨折）的存在会导致损伤发生率减慢。讨论：基线功能状态对于预测损伤变化至关重要，而医学诊断的影响很大，但弱于基线损伤的影响。
Objectives: This study reports findings on functional change trajectories for long-stay residents by examining the effects of baseline medical conditions and functional status on changes in physical impairment across residents' length of stay (LOS). Method: A 5% sample of nursing home residents from Michigan from 1999 through 2003 was used to create longitudinal episodes of care including Minimum Data Set (MDS) assessments. Data were analyzed using hierarchical linear models. Results: On average, physical impairment increases throughout a resident's stay and is more rapid later in the stay. Greater physical and cognitive impairment at baseline leads to increasing impairment for residents whereas presence of baseline medical conditions, including heart disease and hip fracture, leads to slower rates of impairment. Discussion: Baseline functional status is critical to predicting changes in impairment while the impact of medical diagnoses is significant but weaker than the effect of baseline impairment.