Burdens of multimorbidity on hospitalization and mortality in nursing home residents with obesity

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PROJECT SUMMARY Nursing home residents, like Americans of all ages, suffer increasingly from obesity. Obesity develops frequently in the presence of other chronic conditions, including cardiovascular diseases, diabetes, arthritis, and some cancers. Compared to those with normal weight, residents with obesity experience more pain with activity, and typically have more difficulty rising from a chair, walking, and maintaining balance. Thus, care providers in nursing homes increasingly face the prospect of simultaneously managing multiple chronic conditions and functional limitations among these residents. Using national Minimum Data Set (MDS) and Medicare Provider Analysis and Review (MedPAR) files (2012-2015), this R03 project aims to 1) characterize constellations of multimorbidity among nursing home residents with obesity. This will include: a) identifying the most common 1, 2, 3, 4, 5, or 5 above concurrent conditions; and b) distinguishing patterns of constellations of multimorbidity among residents with class I, class II and class III obesity, respectively. 2) assess the impact of multimorbidity, found in A1, on death among nursing home residents with obesity. 3) assess the impact of multimorbidity, found in A1, on hospitalization among nursing home residents with obesity. This study will provide descriptive information of constellations of prevalent conditions among nursing home residents with obesity, and identify subgroups of these individuals at high risk of preventable hospitalization and of mortality. The study results will support clinicians with insight about how interventions to improve care can be targeted to individuals in high-risk groups. This study addresses the Department of Health and Human Services' 2010 Strategic Framework on Multiple Chronic Conditions, which calls for studies to “understand the epidemiology of multiple chronic conditions” (Goal 4, Objective B) and augment the currently limited research about “the constellations of conditions that are most prevalent and most important …[and] to inform effective interventions.”