Discharge to home uncommon in elderly
Less than 20 percent of elderly adults in immediate care facilities are discharged to their homes, a recent Japan study reports. Older age, need for greater care and the presence of several medical conditions are among the factors that appear to be significantly related to discharge to home.
Researchers accessed the information of 342,758 elderly individuals (mean age 84.3±8.2 years; 31.4 percent male) admitted to geriatric immediate care centres. Over the 2-year follow-up, only 65,210 participants (19.0 percent) were discharged to home.
In comparison, 21.0 percent (n=72,047) were transferred to a hospital, 10.2 percent (n=34,879) were transferred to other long-term care (LTC) facilities, 1.4 percent (n=4,674) were transferred to another place, 3.7 percent (n=12,659) died, and 7.0 percent (n=23,954) were discharged but were missing destination information.
After 1 year, the cumulative incidence of discharge to home was only 20.7 percent (95 percent CI, 20.5–20.8).
The multivariable competing-risk Cox proportional hazards regression model showed that older age (hazard ratio [HR] per 1-year increase, 0.98; 0.98–0.98; p<0.001), higher level of care needed (HR for level 5 vs level 1, 0.51; 0.49–0.53; p<0.001) and the presence of dementia (HR, 0.68; 0.65–0.72; p<0.001) were all associated with a decreased likelihood of discharge to home.
In comparison, males (HR, 1.07; 1.05–1.09; p<0.001) and those who received home-based LTC services a month before admission (HR, 2.53; 2.46–2.61; p<0.001) were more likely to be discharged to home.