title: Predictors of nursing home placement and home nursing services utilization by elderly patients after hospital discharge in Taiwan.
abstract: BACKGROUND
  Providing appropriate follow-up health/long-term care services after hospital discharge for elderly persons is important to enhance health and quality of life. Therefore, identifying factors that affect follow-up service utilization has become an important concern. Most studies of predictors of follow-up service utilization for elderly persons after discharge were conducted in the United States of America (USA). Taiwan differs substantially from the USA in health care system, clinical practice, case-mix, culture, and social organization; thus the findings from the USA need to be validated in Taiwan to ensure appropriate discharge referrals.
  
  
  OBJECTIVE
  To investigate pre-discharge predictors of follow-up care including home nursing services and nursing home placement for elderly patients, discharged from hospitals in Taiwan.
  
  
  METHODS
  A prospective study with a case-control design was used.
  
  
  RESULTS
  The strongest predictors of institutionalization in a nursing home at 1, 3 and 6 months after discharge were the elderly person's pre-admission institutionalization (0.33 to 0.48) and the caregiver's preference for institutional displacement (0.23 to 0.85). The strongest predictors of use of home nursing services were the elder's self-care ability (0.69 to 0.76), conscious level (0.51 to 0.73), and tubes remaining before discharge (0.58 to 0.79). These predictors were stable at 1, 3 and 6 months after discharge and could correctly classify 60-89% of sample.
  
  
  CONCLUSIONS
  When taking nursing home and home nursing utilization into considerations at the same time, the elderly person's pre-admission institutionalization and the caregiver's preference for institutional displacement strongly predicted nursing home utilization after hospital discharge. The elder's self-care ability, conscious level, and tubes remaining before discharge strongly predicted the use of home nursing services after discharge.
authors: Graduate Institute of Nursing, Chang Gung University, Taiwan. yeaing@mail.cgu.edu.tw
authors: Yea-Ing Lotus
authors: YI
authors: Shyu
authors: Hsiao-Chin
authors: HC
authors: Lee
mesh_terms: D000359:Aftercare / Q000458:organization & administration / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D016022:Case-Control Studies; D003266:Continuity of Patient Care; D005260:Female; D015577:Geriatric Assessment; D006699:Home Care Services / Q000706:statistics & numerical data*; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D007388:Internal Medicine; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010351:Patient Discharge; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013624:Taiwan