Understanding Pathways into Care homes using Data (UnPiCD study): a retrospective cohort study using national linked health and social care data.
Background Pathways into care are poorly understood but important life events for individuals and their families. UK policy is to avoid moving-in to care homes from acute hospital settings. This assumes that moves from secondary care represent a system failure. However, those moving to care homes fr...
| Publicado en: | Age & Ageing Vol. 51; no. 12; pp. 1 - 12 |
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| Autores principales: | , , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Dec2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=161116536&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 161116536 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Dec2022 vid: 51 iid: 12 pid: 622 pub: Oxford University Press / USA artinfo: ui: 161116536 10.1093/ageing/afac304 ppf: 1 ppct: 11 formats: tig: atl: Understanding Pathways into Care homes using Data (UnPiCD study): a retrospective cohort study using national linked health and social care data. aug: au: Burton, Jennifer Kirsty Ciminata, Giorgio Lynch, Ellen Shenkin, Susan D Geue, Claudia Quinn, Terence J affil: Academic Geriatric Medicine, School of Cardiovascular & Metabolic Health, University of Glasgow , Glasgow, Scotland Health Economics and Health Technology Assessment, School of Health & Wellbeing, University of Glasgow , Glasgow, Scotland Social Care Analytical Unit, Health and Social Care Analysis, Scottish Government , Edinburgh, Scotland Ageing and Health Research Group and Advanced Care Research Centre, Usher Institute, University of Edinburgh , Edinburgh, Scotland su: Retrospective studies Hospital admission & discharge Nursing care facilities Confidence intervals Multivariate analysis Medical protocols Independent living Descriptive statistics Logistic regression analysis Odds ratio Longitudinal method sug: subj: Retrospective studies Hospital admission & discharge Nursing care facilities Community care facilities for the elderly Nursing Care Facilities (Skilled Nursing Facilities) Confidence intervals Multivariate analysis Medical protocols Independent living Descriptive statistics Logistic regression analysis Odds ratio Longitudinal method keyword: Care home data linkage hospital older people routine data social care Care home data linkage hospital older people routine data social care ab: Background Pathways into care are poorly understood but important life events for individuals and their families. UK policy is to avoid moving-in to care homes from acute hospital settings. This assumes that moves from secondary care represent a system failure. However, those moving to care homes from community and hospital settings may be fundamentally different groups, each requiring differing care approaches. Objective To characterise individuals who move-in to a care home from hospital and compare with those moving-in from the community. Design and setting A retrospective cohort study using cross-sectoral data linkage of care home data. Methods We included adults moving-in to care homes between 1/4/13 and 31/3/16, recorded in the Scottish Care Home Census. Care home data were linked to general and psychiatric hospital admissions, community prescribing and mortality records to ascertain comorbidities, significant diagnoses, hospital resource use, polypharmacy and frailty. Multivariate logistic regression identified predictors of moving-in from hospital compared to from community. Results We included 23,892 individuals moving-in to a care home, 13,564 (56.8%) from hospital and 10,328 (43.2%) from the community. High frailty risk adjusted Odds Ratio (aOR) 5.11 (95% Confidence Interval (CI): 4.60–5.68), hospital discharge with diagnosis of fracture aOR 3.91 (95%CI: 3.41–4.47) or stroke aOR 8.42 (95%CI: 6.90–10.29) were associated with moving-in from hospital. Discharge from in-patient psychiatry was also a highly significant predictor aOR 19.12 (95%CI: 16.26–22.48). Conclusions Individuals moving-in to care homes directly from hospital are clinically distinct from those from the community. Linkage of cross-sectoral data can allow exploration of pathways into care at scale. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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