Table 1. Before/After Changes in Hospitalization Rates, Hospital Days, and Community Discharge Rates for TNH and CNH Patients1.
| TNH Patients | CNH Patients | Before/After Change | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
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TNH Change | CNH Change | Mean Difference | Significance3 | Case-Mix Adjusted4 | ||||||
| Before Mean | After Mean | Significance2 | Before Mean | After Mean | Significance2 |
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| Difference | Significance | |||||||||||
|
Hospitalization Rates (Admission Sample Patients) |
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| Percent Hospitalized in: | Percent | Percent | ||||||||||
| 3 Months | 19.3 | 12.3 | .015 | 13.2 | 18.1 | .130 | -7.0 | 4.9 | -11.9 | .007 | -17.2 | .005 |
| 6 Months | 20.6 | 14.1 | .010 | 21.5 | 21.9 | .943 | -6.5 | 0.4 | -6.9 | .109 | -9.9 | .073 |
| 12 Months | 25.3 | 16.0 | .003 | 28.0 | 25.1 | .408 | -9.3 | -2.9 | -6.4 | .128 | -10.9 | .061 |
| Live Discharges | ||||||||||||
| Percent Discharged to Hospital | 41.5 | 27.0 | <.001 | 42.2 | 42.8 | .765 | -14.5 | 0.6 | -15.1 | .016 | -12.5 | .055 |
|
Hospital Days (Admission Sample Patients) |
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| Hospitals Days in: | Days | Days | ||||||||||
| 3 Months | 2.3 | 0.7 | .009 | 0.7 | 1.2 | .053 | -1.6 | 0.5 | -2.1 | <.001 | -2.3 | <.001 |
| 6 Months | 3.0 | 1.0 | .006 | 1.5 | 1.7 | .098 | -2.0 | 0.3 | -2.3 | .001 | -2.2 | .002 |
| 12 Months | 3.4 | 1.3 | .003 | 2.5 | 2.3 | .609 | -2.1 | -0.2 | -1.9 | .030 | -2.2 | .013 |
|
Community Discharge Rates (Admission Sample Patients) |
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| Percent Discharged to Community in: | Percent | Percent | ||||||||||
| 3 Months | 34.0 | 45.7 | .001 | 25.2 | 29.2 | .246 | 11.7 | 4.7 | 7.0 | .355 | 0.7 | .882 |
| 6 Months | 38.5 | 48.1 | .002 | 26.0 | 34.1 | .047 | 9.6 | 8.1 | 1.5 | .982 | -7.6 | .229 |
| 12 Months | 39.4 | 48.3 | .003 | 28.8 | 35.3 | .078 | 8.9 | 6.5 | 2.4 | .820 | -4.7 | .461 |
Retrospective and prospective admission sample sizes are presented in the article. The results for live discharges are based on an overall sample size of 2,437 discharges.
Exact significance level for comparisons of hospitalization rates and community discharge rates are based on Fisher's exact test or the chi-square test approximation to Fisher's test. For comparisons of hospital days, significance levels are based on t-tests or Wilcoxon tests, depending on the underlying probability distribution.
For hospitalization rate and community discharge rate comparisons, the exact significance level for unadjusted mean differences based on significance of the coefficient of an interaction dichotomy (TNH × intervention [post] period) in a logistic regression model that also included dichotomies for pre/post and TNH/CNH. For comparisons involving hospital days, an ordinary least squares regression model was used.
Significance of the adjusted mean difference is the significance of the coefficient of the (TNH × post) interaction in a logistic (ordinary, for hospital days) regression model with case-mix covariates/risk factors and the pre/post and TNH/CNH dichotomies present. The adjusted mean difference was estimated from this logistic (ordinary, for hospital days) regression model.
NOTES: “Before” includes 1981-82. “After” includes 1985-87. TNH is teaching nursing home. CNH is comparison nursing home.
SOURCE: Primary data collected by nursing home and research staff on Teaching Nursing Home Program study patients (from TNHs and CNHs).