Health and discharge outcomes among younger and older nursing home residents

Approximately 10 percent of nursing home (NH) residents in the United States are younger than 65 years old. However, we know little about this population, in part, due to insufficient sample sizes in national surveys. Using the combined 1997 and 1999 National Nursing Home Survey patient discharge data, we compared socio-demographics, health conditions, service utilization, and discharge outcomes between younger (aged <65) and older residents (aged ≥ 65). The analytical sample included 13,589 individuals discharged from nursing homes, of which, 1,514 individuals were under the age of 65. Younger residents were predominately male, white, and not married. They were more likely than older residents to have psychoses, diabetes, or multiple sclerosis whereas older residents were more likely to have hypertension, heart disease, or stroke. The percentages of mental health, dental, and transportation service utilization were higher in younger residents than in older residents. Logistic regression models were applied to examine factors associated with health outcomes at discharge. The odds of improved outcomes (i.e., stabilized health or recovery) were greater among younger residents and those who had a shorter length of stay, less co-morbidity, and certain diagnoses (e.g., stroke, fractures, or post procedural states). The odds of being discharged to a hospital or another nursing home were greater among older residents and those who had diabetes, pneumonia, or urinary tract infection. These findings suggest that younger and older NH residents vary greatly in their health conditions, service utilization, and discharge outcomes raising questions about optimal care settings for these subgroups.