Pathways to hospital death among the oldest old.
Using the 1986 National Mortality Followback Survey (N = 2,090), this research examines the conditions under which the oldest old (85+ years of age) are discharged from a nursing home to enter and die in a hospital as well as the conditions under which community dwellers enter and die in a hospital. Given the need to plan for health services for this growing population and the recent policy changes in length of hospital stay, this analysis focuses on pathways leading to a hospital death. Results suggest that the factors that influence site of death are necessarily quite distinct for those who have entered the institutional long-term care system versus those who have not. Among institutionalized patients, the incidence of an acute condition appears to precipitate hospitalization, whereas among community dwellers, the presence of a social support network and the decedent's race are the only salient factors predicting hospital death. Implications are discussed.
Department of Sociology, Clark University, Worcester, MA 01610.
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D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection; D005069:Evaluation Studies as Topic; D006302:Health Services Research; D017052:Hospital Mortality; D006801:Humans; D015999:Multivariate Analysis; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data*; D012107:Research Design; D014481:United States / Q000453:epidemiology