Approximately 14% of nursing facility residents have pneumonia infections during the course of a year. Of these, over one-third are hospitalized, presenting substantial costs to Medicare. The necessity of hospitalization is not always clear when considering the risk of nosocomial infection and the stress of transfer, particularly for frail residents. No national studies to date have considered the risk factors for hospitalization separately from those for acquiring pneumonia. This study assesses the resident- and facility-level risk factors for hospitalization, conditional on having pneumonia.
The analysis uses the 1996 Medical Expenditure Panel Survey Nursing Home Component, a nationally representative sample of nursing home residents including 3,209 residents as of January 1, 1996 and 2,690 persons admitted to a nursing home in 1996 from 815 facilities. During the year, 855 residents in the sample had pneumonia infections and 304 were hospitalized for it. A logit model is used to identify risk factors for hospitalization among the 855 with pneumonia infections.
The results indicate that frailer residents are less likely to be hospitalized, consistent with the risks associated with transfers. Furthermore, residents in facilities with higher RN-to-resident ratios are less likely to be hospitalized, providing additional evidence that higher professional staffing in nursing homes could play an important role in the reduction of hospitalization rates. The findings have implications for risk-adjustment and Medicare costs.
Learning Objectives: 1. List the facilty- and resident-level risk factors associated with hospitalization for nursing facility residents with pneumonia. 2. View the risk factors for hospitalization separately from the risk factors for acquiring pneumonia.
Keywords: Nursing Homes, Risk Factors
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.