End-of-life hospitalization for African American and non-Latino white nursing home residents: variation by race and a facility's racial composition.
End-of-life hospitalization for African American and non-Latino white nursing home residents: variation by race and a facility's racial composition.
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非裔美国人和非拉丁裔白人疗养院居民的临终住院治疗：因种族和设施的种族构成而异。
DOI：
10.1089/jpm.2005.8.58
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Miller,SusanC
中科院分区：
文献类型：
--
作者：
Mor,Vincent;Papandonatos,George;Miller,SusanC
背景：养老院居民在生命结束时住院是很常见的，尤其是在非洲裔美国人中。目的：本研究探讨了种族之间的关联，一个养老院的种族混合，并结束了生命的hospitalization.Design：这是一个回顾性队列研究设置/Subjects.Studied是疗养院居民在纽约（n= 14，159）和密西西比（n= 1481）谁死在1995-1996年，并有一个最小数据集（MDS）的评估在120天内death.Measurements：结果措施住院的几率在生命的最后90天。一个变量反映了一个疗养院的比例的非洲裔美国人居民（在1995-1996年）代表疗养院的种族mix.Results：46%的非洲裔美国人和32%的白人住院在过去90天的生活。在控制了人口统计学、诊断、功能、患者偏好之后，（不复苏[DNR]）和设施资源，非裔美国人居民比例较高的设施中的疗养院居民住院的几率更大（调整后的比值比[AOR] 1.14; 95%置信区间[CI] 1.10，纽约为1.18;密西西比为1.35; 95% CI 1.24，1.46）。年龄和虚弱与种族相互作用;年长的非洲裔美国人有16%的可能性（95% CI 1.08，1.24），非裔美国人有更多的功能限制，有37%（95%CI 1.24，1.51）住院的可能性大于可比白人。非洲裔美国人的临终住院率似乎较高，这归因于大多数人居住的设施，以及老年人或功能受限的居民的差别化住院。
Background:Hospitalization of nursing home residents at the end of life is common, more so among African Americans. Whether a nursing home's racial mix is associated with hospitalization is unknown.Objective:This study examined the association between race, a nursing home's racial mix, and end-of-life hospitalization.Design:This was a retrospective cohort study.Setting/Subjects.Studied were nursing home residents in New York (n= 14,159) and Mississippi (n= 1481) who died in 1995–1996 and had a minimum data set (MDS) assessment within 120 days of death.Measurements:The outcome measure was the odds of hospitalization in the last 90 days of life. A variable reflecting a nursing home's proportion of African American residents (in 1995–1996) represented a nursing home's racial mix.Results:Forty-six percent of African Americans and 32% of whites were hospitalized in the last 90 days of life. After controlling for demographics, diagnoses, function, patient preferences (do-not-resuscitate [DNR]), and facility resources, nursing home residents in facilities having higher proportions of African American residents had greater odds of hospitalization (adjusted odds ratio [AOR] 1.14; 95% confidence interval [CI] 1.10, 1.18 in New York and AOR 1.35; 95% CI 1.24, 1.46 in Mississippi). Age and frailty interacted with race; older African Americans had a 16% greater likelihood (95% CI 1.08, 1.24) of hospitalization, and African Americans with more functional limitations had a 37% (95% CI 1.24, 1.51) greater likelihood of hospitalization than did comparable whites.Conclusions:It appears higher end-of-life hospitalization rates for African American residents are attributable to the facilities where most reside, and to differential hospitalization of older or more functional limited residents.
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影响因子：
3
作者：
Gambassi, G;Landi, F;Bernabei, R
通讯作者：
Bernabei, R
影响因子：
158.5
作者：
Chen, J;Rathore, SS;Krumholz, HM
通讯作者：
Krumholz, HM
临终疗养院转移政策对公立急症护理医院的影响
影响因子：
6.3
作者：
W. R. Smith;A. Kellerman;James S. Brown
通讯作者：
James S. Brown
疗养院出院状况的决定因素
影响因子：
3
作者：
W. Weissert;W. Scanlon
通讯作者：
W. Scanlon
DOI：
10.1111/j.1532-5415.1999.tb02573.x
发表时间：
1999-05-01
影响因子：
6.3
作者：
Mebane, EW;Oman, RF;Goldstein, MK
通讯作者：
Goldstein, MK