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Nursing factors associated with length of stay and readmission rate of the elderly residents from nursing home based on LTCfocus database.
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- Author(s): Zhang, Yunping (AUTHOR); Zhao, Xueping (AUTHOR); Zhao, Beibei (AUTHOR); Xu, Lu (AUTHOR); Chen, Xiaofang (AUTHOR); Ruan, Aichao (AUTHOR)
- Source:
Public Health (Elsevier). Dec2022, Vol. 213, p19-27. 9p. - Source:
- Additional Information
- Subject Terms: LENGTH of stay in hospitals; NURSING home patients; CROSS-sectional method; MULTIVARIATE analysis; MULTIPLE regression analysis; PATIENT readmissions; MACHINE learning; NURSING care facilities; PSYCHOSOCIAL factors; QUALITY assurance; DESCRIPTIVE statistics; CLUSTER analysis (Statistics); LONG-term health care; ALGORITHMS; OLD age
- Subject Terms:
- Abstract: Nursing factors have been found to be associated with a reduction in readmission rates. Nevertheless, few attentions have been given to the effect of nursing factors on nursing home (NH) residents. This study was to assess the impact of nursing factors on the hospital readmissions and length of stay (LOS) of the elderly residents from the NH. This was a cross-sectional study. Data were extracted from the NH of the LTCFocus.org data set between 2011 and 2018. The study included residents aged ≥55 years who were admitted to NH in the United States, following a hospitalization event. The nursing factors included facility-level data elements and medical care personnel. An unsupervised machine learning algorithm (K-means) was used to cluster NH according to readmission rate and LOS. Multivariate logistic regression analysis was performed. This study consisted of 107,000 NH-year observations. The median readmission rate was 17%, with a median LOS was 28.00 days. Three clusters were identified: cluster 1 was a high readmission rate with high LOS, cluster 2 was a low readmission rate with low LOS, and cluster 3 was a high readmission rate with low LOS. Multifacility and admission/bed were associated with a reduction in readmission rate and LOS in both cluster 1 vs cluster 2 and cluster 3 vs cluster 2. The special care unit and registered nurses' ratio were associated with decreased readmission rate and LOS in cluster 1 vs cluster 2. Total beds and Alzheimer unit decreased the readmission rate and LOS, whereas certified nursing assistant increased the readmission rate and LOS in cluster 3 vs cluster 2. NH for profit was associated with elevated readmission rate and LOS in cluster 1 vs cluster 2 and decreased readmission rate and LOS in cluster 3 vs cluster 2. Based on the subgroup analysis, the certified nursing assistant decreased readmission rate and LOS in cluster 1 vs cluster 2 and increased readmission rate and LOS in cluster 3 vs cluster 2 (all P < 0.005). This study indicates the importance of the improvement of nurse number and level and the inputs of facility characteristics in NH. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Public Health (Elsevier) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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