Predictors of Nursing Home Hospitalization: A Review of the Literature

Hospitalization of nursing home residents is costly and potentially exposes residents to iatrogenic disease and psychological harm. This article critically reviews the association between the decision to hospitalize and factors related to the residents' welfare and preferences, the providers�...

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Bibliographic Details
Published in:Medical Care Research and Review 2008-02, Vol.65 (1), p.3-39
Main Authors: Grabowski, David C., Stewart, Kate A., Broderick, Suzanne M., Coots, Laura A.
Format: Article
Language:English
Subjects:
Advance directives
Ancillary services
Attitudes
Decision making
Forecasting
Government programs
Health care
Health care policy
Health policy
Health services
Home health care
Home ownership
Hospice care
Hospices
Hospitalization
Humans
Medicaid
Medical decision making
Medicare
Mental health services
Nurses
Nursing homes
Nursing Homes - utilization
Ownership
Physicians
Policies
Preferences
Public finance
Residents
Selection bias
Social welfare
Staffing
Treatment preferences
United States
Welfare
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Summary:Hospitalization of nursing home residents is costly and potentially exposes residents to iatrogenic disease and psychological harm. This article critically reviews the association between the decision to hospitalize and factors related to the residents' welfare and preferences, the providers' attitudes, and the financial implications of hospitalization. Regarding the resident's welfare, factors associated with hospitalization included sociodemographics, health characteristics, nurse staffing, the presence of ancillary services, and the use of hospices. Patient preferences (e.g., advance directives) and provider attitudes (e.g., overburdening of staff) were also associated with increased hospitalization. Finally, financial variables related to hospitalization included nursing home ownership status and state Medicaid policies, such as nursing home payment rates and bed-hold requirements. Most studies relied on potentially confounded research designs, which leave open the issue of selection bias. Nevertheless, the existing literature asserts that nursing home hospitalizations are frequent, often preventable, and related to facility practices and state Medicaid policies.
ISSN:1077-5587
1552-6801
DOI:10.1177/1077558707308754