Table.
Characteristics of Nursing Home Residents with Advanced Dementia (n=4177) and their Associations with Skilled Nursing Facility (SNF) Admission
| Characteristic | All Residents, N= 4177 (%) |
Resident admitted to a SNF N= 2557 (%) |
Resident not admitted to a SNF N=1620 (%) |
Unadjusted odds ratio,1 95% Confidence Interval (CI) |
Adjusted odds ratio,1 95% CI |
|---|---|---|---|---|---|
| Resident characteristics | |||||
| Age in years, mean (SD) | 84.3 (7.1) | 84.3 (7.0) | 84.3 (7.2) | 1.00 (0.99-1.01) | 1.01 (1.00-1.02) |
| Male, no. (%) | 1198 (28.7) | 747 (29.2) | 451 (27.8) | 1.07 (0.93-1.23) | 1.11 (0.95-1.30) |
| Race or ethnic group, no. (%) | |||||
| White | 3337 (79.9) | 2025 (79.2) | 1312 (81.0) | 0.89 (0.76-1.05) | Ref |
| Black | 623 (14.9) | 386 (15.1) | 237 (14.6) | 1.04 (0.87-1.24) | 0.98 (0.80-1.19) |
| Hispanic | 169 (4.1) | 115 (4.5) | 54 (3.3) | 1.37 (0.96-1.94) | 1.30 (0.90-1.88) |
| Other race | 47 (1.1) | 30 (1.2) | 17 (1.1) | 1.12 (0.61-2.05) | 1.03 (0.56-1.89) |
| Comorbidities, no. (%) | |||||
| Diabetes Mellitus | 1039 (24.9) | 604 (23.6) | 435 (26.9) | 0.84 (0.73-0.97) | 0.85 (0.73-0.98) |
| Hypertension | 2289 (54.8) | 1411 (55.2) | 878 (54.2) | 1.04 (0.92-1.18) | 1.07 (0.94-1.22) |
| Coronary artery disease | 654 (15.7) | 396 (15.5) | 258 (15.9) | 0.97 (0.81-1.15) | 0.97 (0.81-1.16) |
| Congestive heart failure | 926 (22.2) | 525 (21.6) | 374 (23.1) | 0.92 (0.79-1.07) | 0.97 (0.83-1.14) |
| Stroke | 995 (23.8) | 599 (23.4) | 396 (24.4) | 0.95 (0.82-1.09) | 0.93 (0.80-1.09) |
| Chronic obstructive pulmonary disease | 551 (13.2) | 333 (13.0) | 218 (13.5) | 0.96 (0.80-1.16) | 0.95 (0.79-1.15) |
| Cancer | 292 (7.0) | 187 (7.3) | 105 (6.5) | 1.14 (0.89-1.46) | 1.14 (0.88-1.48) |
| Activities of Daily Living score, < 28 vs. 28, no. (%) |
1838 (44.0) | 1173 (45.9) | 665 (41.1) | 1.22 (1.07-1.38) | 1.21 (1.05-1.38) |
| Stage II or greater pressure ulcer, no. (%) | 1056 (25.3) | 627 (24.5) | 429 (26.5) | 0.90 (0.78-1.04) | 0.93 (0.79-1.08) |
| ADEPT2 score, > median (12) | 2013 (48.2) | 1260 (49.3) | 753 (46.5) | 1.12 (0.99-1.27) | 1.09 (0.93-1.28) |
| Do-not-resuscitate order, no. (%) | 2302 (55.1) | 1391 (54.4) | 911 (56.2) | 0.93 (0.82-1.06) | 1.02 (0.89-1.17) |
| Primary Diagnostic Related Group for hospitalization, no. (%) |
|||||
| Respiratory infection | 921 (22.1) | 581 (22.7) | 340 (21.0) | 1.11 (0.95-1.29) | 1.14 (0.96-1.34) |
| Nutritional/metabolic disease | 353 (8.5) | 218 (8.5) | 135 (8.3) | 1.03 (0.82-1.28) | 0.97 (0.76-1.23) |
| Urinary tract infection | 450 (10.8) | 276 (10.8) | 174 (10.7) | 1.00 (0.82-1.23) | 1.04 (0.84-1.30) |
| Sepsis | 401 (9.6) | 248 (9.7) | 153 (9.4) | 1.03 (0.83-1.28) | 1.03 (0.82-1.29) |
| Hip fracture | 80 (1.9) | 55 (2.2) | 25 (1.5) | 1.40 (0.87-2.26) | 1.58 (0.97-2.56) |
| Percutaneous gastrostomy tube placed during hospitalization (vs, none or pre-existing tube) |
518 (12.4) | 396 (15.5) | 122 (7.5) | 2.25 (1.81-2.80) | 2.31 (1.85-2.88) |
| Nursing Home Characteristics | |||||
| >100 beds, no. (%) | 2948 (70.6) | 1863 (72.9) | 1085 (67.0) | 1.32 (1.15-1.52) | 1.25 (1.07-1.46) |
| Urban, no. (%) | 3059 (73.3) | 1926 (75.3) | 1133 (70.0) | 1.31 (1.13-1.52) | 1.21 (1.03-1.42) |
| Part of a chain, no. (%) | 2309 (55.3) | 1487 (58.2) | 822 (50.7) | 1.35 (1.18-1.54) | 1.31 (1.14-1.50) |
| For profit, no. (%) | 3024 (72.4) | 1913 (74.8) | 1111 (68.6) | 1.36 (1.18-1.58) | 1.28 (1.09-1.51) |
| Dementia Special Care Unit, no. (%) | 1073 (25.7) | 674 (26.4) | 399 (24.6) | 1.10 (0.95-1.27) | 1.06 (0.91-1.24) |
| Use of NP/PAs, no. (%) | 1075 (25.7) | 667 (26.1) | 408 (25.2) | 1.05 (0.90-1.21) | 1.00 (0.86-1.17) |
| Hospital based, no. (%) | 171 (4.1) | 91 (3.6) | 80 (4.9) | 0.71 (0.52-0.98) | 1.07 (0.75-1.51) |
| Registered nurse hours/resident/day mean (SD) | 0.33 (0.52) | 0.33 (0.44) | 0.35 (0.63) | 0.93 (0.83-1.05) | 0.96 (0.85-1.09) |
| % non white residents above median, | 2090 (50.0) | 1295 (50.7) | 795 (49.1) | 1.06 (0.93-1.21) | 0.94 (0.81-1.09) |
1
Logistic regression, outcome of SNF admission, adjusted for clustering at facility level using robust standard errors
2
Advanced Dementia Prognostic Tool score range, 1-32.5, higher scores indicate higher risk of death