OLDER PATIENTS discharged from hospital to long-term care in nursing homes live 30 months on average, the first study to examine survival in older patients admitted to nursing homes in the Republic has found.
The survival time of these frail elderly patients is just half that of a corresponding group who live in the community.
Dr Conal Cunningham, consultant geriatrician at St James’s Hospital, Dublin, and colleagues from the Mercer’s Institute for Research in Ageing followed 1,552 patients discharged from St James’s to nursing homes in 1997-2003. A random sample of 210 patients from the seven-year period was then chosen for detailed analysis.
The results, published in the current issue of the Irish Medical Journal, show the patients had an average age of 82 and almost one in three was female. On average, the patients studied lived for a further 30.3 months following transfer to a nursing home. This compares with a life expectancy of 67 months for an Irish man aged 82, with women of the same age expected to live for 85 months.
“As this period of study was associated with increasing privatisation of nursing home care in the Greater Dublin area, it is encouraging to note there was no significant association between survival and the public/private status of nursing homes,” the authors noted.
The proportion of patients discharged to private nursing homes rose from 25 per cent at the beginning of the study to 56 per cent at the end. But the authors said their study was not sufficiently powerful to compare outcomes in private versus public nursing homes.
Data from the US, Canada and the UK has shown that public nursing homes look after people with more complex problems and have higher staffing levels. Patients in public nursing homes are hospitalised less for dehydration and pneumonia, suggesting they may be a more appropriate choice for the long-term care of more frail patients.
The study found that 7 per cent of patients died within one month of admission to a nursing home, but this initial high mortality rate dropped with time spent in long-term care. Some 25 per cent of patients were dead one year post-discharge.