Health of Older Adults in Assisted Living and Implications for Preventive Care
Health of Older Adults in Assisted Living and Implications for Preventive Care
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DOI：
10.1093/geront/gnw053
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发表时间：
2017-10-01
期刊：
影响因子：
5.7
通讯作者：
Lewis, Carmen L.
中科院分区：
文献类型：
--
作者：
Kistler, Christine E.;Zimmerman, Sheryl;Lewis, Carmen L.
在住宅护理和辅助生活（RC/AL）的老年人比一般老年人健康状况较差，有些人的需求与养老院的需求相似，使其成为评估潜在过度使用或未充分使用预防服务的重要群体。我们确定了RC/AL居民的健康状况，并区分了那些可能和可能不受益于预防服务的人之间的特征，这些服务要求预期寿命>= 5 years.横断面调查的全国代表性样本的RC/AL居民使用2010年的数据从全国住宅护理设施调查。主要结果是使用三种预测死亡率指数（Charlson Comorbid指数、4年死亡率指数和9年死亡率指数）进行的健康状况加权频率分布，733，300名（加权）居民中共有666，700名符合纳入标准。根据这三个指数，10%-15%的居民健康状况良好，11%-70%的居民处于中等健康状态，20%-76%的居民健康状况不佳。使用三个经过验证的死亡率指数之间的三角测量，10%-15%的RC/AL居民健康状况良好，很可能受益于需要>= 5年预期寿命的预防服务。此外，许多居民的利益不确定，将受益于共同决策。
Older adults in residential care and assisted living (RC/AL) are less healthy than the general elderly population, and some have needs similar to those in nursing homes, making this an important group in which to assess potential overuse or underuse of preventive services. We determined the health status of RC/AL residents and distinguished characteristics between those who may and may not benefit from preventive services requiring a life expectancy >= 5 years.Cross-sectional survey of a nationally representative sample of RC/AL residents using 2010 data from the National Survey of Residential Care Facilities. The primary outcome was the weighted frequency distribution of health states using three predictive mortality indices: Charlson Comorbidity Index, 4-year mortality index, and 9-year mortality index.A total of 666,700 of 733,300 (weighted) residents met criteria for inclusion. Based on the three indices, 10%-15% were in good health, 11%-70% in intermediate health, and 20%-76% in poor health.Using triangulation between 3 well-validated mortality indices, 10%-15% of RC/AL residents are in good health and highly likely to benefit from preventive services that require >= 5 year life expectancy. In addition, many residents have uncertain benefit and would benefit from shared decision making.