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J Am Geriatr Soc. 2012 Oct;60(10):1895-900. doi: 10.1111/j.1532-5415.2012.04146.x. Epub 2012 Sep 24.

Effect of forced transitions on the most functionally impaired nursing home residents.

Author information

  • 1Center for Gerontology and Healthcare Research, Providence, RI 02912, USA. Kali_Thomas@brown.edu

Abstract

OBJECTIVES:

To examine the hospitalization rate and mortality associated with forced mass transfer of nursing home (NH) residents with the highest levels of functional impairment.

DESIGN:

Retrospective cohort study.

SETTING:

One hundred nineteen Texas and Louisiana NHs identified as being at risk for evacuation for Hurricane Gustav.

PARTICIPANTS:

Six thousand four hundred sixty-four long-stay residents residing in at-risk NHs for at least three consecutive months before landfall of Hurricane Gustav.

MEASUREMENTS:

Using Medicare claims and instrumental variable analysis, the mortality (death at 30 and 90 days) and hospitalization rates (at 30 and 90 days) of the most functionally impaired long-stay residents who were evacuated for Hurricane Gustav were compared with those of the most functionally impaired residents who did not evacuate.

RESULTS:

The effect of evacuation was associated with 8% more hospitalizations by 30 and 90 days for the most functionally impaired residents. Evacuation was not significantly related to mortality.

CONCLUSION:

The most functionally impaired NH residents experience more hospitalizations but not mortality as a consequence of forced mass transfer. With the inevitability of NH evacuations for many different reasons, harm mitigation strategies focused on the most impaired residents are needed.

© 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

PMID:
23002792
[PubMed - indexed for MEDLINE]
PMCID:
PMC3530394
Free PMC Article
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