scholarly journals Effect of income on length of stay in a hospital or long‐term care facility among older adults with dementia in Japan

2019 ◽  
Vol 35 (3) ◽  
pp. 302-311
Author(s):  
Fumiko Murata ◽  
Akira Babazono ◽  
Haruhisa Fukuda
Keyword(s):  
Older Adults ◽  
Length Of Stay ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

scholarly journals Determinants of Hospital Length of Stay among Patients with Pneumonia Admitted to a Large Canadian Hospital from 1991 to 2001

2005 ◽  
Vol 12 (7) ◽  
pp. 365-370 ◽  
Author(s):  
Margaret J McGregor ◽  
J Mark FitzGerald ◽  
Robert J Reid ◽  
Adrian R Levy ◽  
Michael Schulzer ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Long Term Care ◽  
Care Facility ◽  
Community Acquired Pneumonia ◽  
Hospital Length Of Stay ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Care Facilities

BACKGROUND: Pneumonia is a common reason for hospital admission, and the cost of treatment is primarily determined by length of stay (LOS).OBJECTIVES: To explore the changes to and determinants of hospital LOS for patients admitted for the treatment of community-acquired pneumonia over a decade of acute hospital downsizing.METHODS: Data were extracted from the database of Vancouver General Hospital, Vancouver, British Columbia, on patients admitted with community-acquired pneumonia (International Classification of Diseases, Ninth Revision, Clinical Modification codes 481.xx, 482.xx, 483.xx, 485.xx and 486.xx) from January 1, 1991 to March 31, 2001. The effects of sociodemographic factors, the specialty of the admitting physician (family practice versus specialist), admission from and/or discharge to a long-term care facility (nursing home) and year of admission, adjusted for comorbidity, illness severity measures and other potential confounders were examined. Longitudinal changes in these factors over the 10-year period were also investigated.RESULTS: The study population (n=2495) had a median age of 73 years, 53% were male and the median LOS was six days. Adjusted LOS was longer for women (10% increase, 95% CI 3 to 16), increasing age group (7% increase, 95% CI 4 to 10), admission under a family physician versus specialist (42% increase, 95% CI 32 to 52) and admission from home with subsequent discharge to a long-term care facility (75% increase, 95% CI 47 to 108). Adjusted hospital LOS decreased by an estimated 2% (95% CI 1 to 3) per annum. The mean age at admission and the proportion admitted from long-term care facilities both increased significantly over the decade (P<0.05).CONCLUSIONS: Results suggest that the management of hospitalized patients with pneumonia changed substantially between 1991 and 2001. The interface of long-term care facilities with acute care would be an important future area to explore potential efficiencies in caring for patients with pneumonia.

scholarly journals Clinical features and risk factors for mortality among long-term care facility residents hospitalized due to COVID-19 in Spain

2021 ◽  
Author(s):  
José-Manuel Ramos-Rincón ◽  
Máximo Bernabeu-Whittel ◽  
Isabel Fiteni-Mera ◽  
Almudena López-Sampalo ◽  
Carmen López-Ríos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Long Term Care ◽  
Functional Dependence ◽  
Care Facility ◽  
Community Dwelling ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

Abstract Background COVID-19 severely impacted older adults and long-term care facility (LTCF) residents. Our primary aim was to describe differences in clinical and epidemiological variables, in-hospital management, and outcomes between LTCF residents and community-dwelling older adults hospitalized with COVID-19. The secondary aim was to identify risk factors for mortality due to COVID-19 in hospitalized LTCF residents. Methods This is a cross-sectional analysis within a retrospective cohort of hospitalized patients≥75 years with confirmed COVID-19 admitted to 160 Spanish hospitals. Differences between groups and factors associated with mortality among LTCF residents were assessed through comparisons and logistic regression analysis. Results Of 6,189 patients≥75 years, 1,185 (19.1%) were LTCF residents and 4,548 (73.5%) were community-dwelling. LTCF residents were older (median: 87.4 vs. 82.1 years), mostly female (61.6% vs. 43.2%), had more severe functional dependence (47.0% vs 7.8%), more comorbidities (Charlson Comorbidity Index: 6 vs 5), had dementia more often (59.1% vs. 14.4%), and had shorter duration of symptoms (median: 3 vs 6 days) than community-dwelling patients (all, p&lt;.001). Mortality risk factors in LTCF residents were severe functional dependence (aOR:1.79;95%CI:1.13-2.83;p=.012), dyspnea (1.66;1.16-2.39;p=.004), SatO2&lt;94% (1.73;1.27-2.37;p=.001), temperature≥37.8ºC (1.62;1.11-2.38; p=.013); qSOFA index≥2 (1.62;1.11-2.38;p=.013), bilateral infiltrates (1.98;1.24-2.98;p&lt;.001), and high C-reactive protein (1.005;1.003-1.007;p&lt;.001). In-hospital mortality was initially higher among LTCF residents (43.3% vs 39.7%), but lower after adjusting for sex, age, functional dependence, and comorbidities (aOR:0.74,95%CI:0.62-0.87;p&lt;.001). Conclusion Basal functional status and COVID-19 severity are risk factors of mortality in LTCF residents. The lower adjusted mortality rate in LTCF residents may be explained by earlier identification, treatment, and hospitalization for COVID-19.

Staphylococcus aureus Nasal Colonization and Colonization or Infection at Other Body Sites in Patients on a Burn Trauma Unit

2009 ◽  
Vol 30 (8) ◽  
pp. 721-726 ◽  
Author(s):  
Amber Reighard ◽  
Daniel Diekema ◽  
Lucy Wibbenmeyer ◽  
Melissa Ward ◽  
Loreen Herwaldt
Keyword(s):  
Staphylococcus Aureus ◽  
Length Of Stay ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Burn Trauma ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Trauma Unit

Objective.To determine whether Staphylococcus aureus isolates from the nares of patients on a burn trauma unit were related to isolates colonizing or infecting other body sites.Design.Active surveillance for S. aureus, a case-control study, and pulsed-field gel electrophoresis of S. aureus isolates.Setting.A burn trauma unit of a Midwestern university teaching hospital.Patients.Patients admitted from February 1, 2002, through March 30, 2007, who had S. aureus isolated either from a nasal culture and from another body site (case patients) or from a nasal culture alone (control subjects).Results.Nineteen patients met the case patient definition and had paired isolates from the nares and an additional site available for typing. Of the 19 case patients, 8 had infections, 7 of which were caused by methicillin-resistant S. aureus (5 USA100 strain and 2 USA300 strain). A total length of stay of more than 3 weeks (odds ratio [OR], 8.75 [95% confidence interval {CI}, 2.2–34.6]; P = .002), residence in a long-term care facility (OR, 9.4 [95% CI, 2.1–42.5]; P = .004), and diabetes (OR, 3.2 [95% CI, 1.0–10.0]; P = .05) were associated with the isolation of S. aureus from the nares and other sites. Seventeen case patients (89.5%) had closely related isolates obtained from culture of samples from the nares and from other sites.Conclusions.Prolonged length of stay, diabetes, or residing in a long-term care facility increased the risk of having S. aureus at sites other than the nares. S. aureus isolates from other body sites usually were closely related to nasal isolates. Most case patients had colonized or infected wounds that could be a source of S. aureus for other patients.

Singing for Health, Connection and Care

2015 ◽  
Vol 7 (4) ◽  
pp. 13 ◽  
Author(s):  
Amy Clements-Cortés
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Care Facility ◽  
Significant Others ◽  
Clinical Effects ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Choral Singing

Singing Together was the third part of a multi-phase investigation examining the benefits of singing with older adults in an adult daycare program (Phase 1), and in a long-term care facility (Phases 2 and 3). Phase 3 focused on residents of a long-term care facility who were diagnosed with mild to moderate cognitive impairment and Alzheimer’s disease, and was unique in its extended scope of examining their choral participation with caregivers, or significant others. Pain, energy level, and mood were assessed using multiple objective and self-reported tools. Results of 16 weeks of choir sessions indicate statistically significant reduced perceptions of pain and increased energy and mood for both residents and significant others. Qualitative themes in this study included: encourages maximized participation; facilitates interaction and bonding; promotes enjoyment and fun; encourages improved mood and attitude; facilitates energy and motivation; promotes stress release and relaxation; and singing as a recognized therapy. Future implications of these findings will be discussed as well as overall analysis of the research project. A literature review outlining the effects of clinical choral singing with respect to older adults was provided in Part1: Clinical Effects of Choral Singing for Older Adults [1]of this two part paper.

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