Next Article in Journal
What Is the Evidence for Early Mobilisation in Elective Spine Surgery? A Narrative Review
Previous Article in Journal
Learning in Practice: Collaboration Is the Way to Improve Health System Outcomes
Previous Article in Special Issue
End-of-Life Care Challenges from Staff Viewpoints in Emergency Departments: Systematic Review
Open AccessArticle

Long-Term Care Admissions Following Hospitalization: The Role of Social Vulnerability

1
Division of Geriatric Medicine, Nova Scotia Health Authority, Dalhousie University, 5955 Veterans’ Memorial Lane, Halifax, NS B3H 2E1, Canada
2
Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 4R2, Canada
3
Division of Infectious Diseases, Dalhousie University, Halifax, NS B3H 4R2, Canada
*
Author to whom correspondence should be addressed.
Healthcare 2019, 7(3), 91; https://doi.org/10.3390/healthcare7030091
Received: 30 May 2019 / Revised: 9 July 2019 / Accepted: 11 July 2019 / Published: 15 July 2019
(This article belongs to the Special Issue Aging, Chronic Disease, and the Impact of Long Term Care)
We sought to understand the association between social vulnerability and the odds of long-term care (LTC) placement within 30 days of discharge following admission to an acute care facility and whether this association varied based on age, sex, or pre-admission frailty. Patients admitted to hospital with acute respiratory illness were enrolled in the Canadian Immunization Research Network’s Serious Outcomes Surveillance Network during the 2011/2012 influenza season. Participants (N = 475) were 65 years or older (mean = 78.6, SD = 7.9) and over half were women (58.9%). Incident LTC placement was rare (N = 15); therefore, we used penalized likelihood logistic regression analysis. Social vulnerability and frailty indices were built using a deficit accumulation approach. Social vulnerability interacted with frailty and age, but not sex. At age 70, higher social vulnerability was associated with lower odds of LTC placement at high levels of frailty (frailty index (FI) = 0.35; odds ratio (OR) = 0.32, 95% confidence interval (CI) = 0.09–0.94), but not at lower levels of frailty. At age 90, higher social vulnerability was associated with greater odds of LTC placement at lower levels of frailty (FI = 0.05; OR = 14.64, 95%CI = 1.55, 127.21 and FI = 0.15; OR = 7.26, 95%CI = 1.06, 41.84), but not at higher levels of frailty. Various sensitivity analyses yielded similar results. Although younger, frailer participants may need LTC, they may not have anyone advocating for them. In older, healthier patients, social vulnerability was associated with increased odds of LTC placement, but there was no difference among those who were frailer, suggesting that at a certain age and frailty level, LTC placement is difficult to avoid even within supportive social situations. View Full-Text
Keywords: social vulnerability; frailty; long-term care placement; social vulnerability index; frailty index social vulnerability; frailty; long-term care placement; social vulnerability index; frailty index
MDPI and ACS Style

Godin, J.; Theou, O.; Black, K.; McNeil, S.A.; Andrew, M.K. Long-Term Care Admissions Following Hospitalization: The Role of Social Vulnerability. Healthcare 2019, 7, 91.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop