title: [Analysis of placement in public nursing homes after hospital admission in the fragile elderly].
abstract: BACKGROUND
  To analyze placement in public nursing homes in elderly inpatients referred by the social work unit.
  
  
  METHODS
  We performed a cohort study in an acute geriatric unit of a tertiary hospital. The sociodemographic, clinical, functional and socioeconomic data registered on admission (inclusion period: 4 years) were analyzed. The patients were followed-up for 6 months after discharge. The percentage gaining places in public nursing homes, the waiting time (monthly incidence rate) and the reasons for not gaining a place were evaluated. The variables associated with gaining a place were introduced into a multivariate logistic regression model.
  
  
  RESULTS
  A total of 415 elders were referred to public nursing homes. The mean age was 85.1 years (SD=6.7), and 61.9% were women. During the follow-up period, 72 elders were granted a place (17.3%; monthly incidence rate 3.14%). In the multivariate analysis, the factors independently associated with gaining a place at a public nursing home were living alone (OR 2.788; p=0.005), having a lower income (OR 0.807; p=0.018), having a social work report from the hospital (OR 2.132; p=0.037), having previously requested a place at a public nursing home (OR 3.298; p=0.002) and discharge destination other than the home (OR 5.792; p<0.001). The main causes associated with not gaining a place were death while on the waiting list (41.4%) and not completing the paperwork (32.9%).
  
  
  CONCLUSIONS
  Hospitalization in the frail elderly frequently leads to requests for public nursing home admission, although few places are granted in the short term to patients in the acute unit. Certain socioeconomic factors and referral by social workers were positively associated with gaining a place. However, the waiting time leads to a substantial proportion of deaths and incomplete paperwork, largely due to the complexity of the process.
authors: Servicio de Geriatría, Hospital Clínico San Carlos, Madrid, España.
authors: Jesús
authors: J
authors: Mora Fernández
authors: Luis José
authors: LJ
authors: Silveira Guijarro
authors: Nieves
authors: N
authors: Calcerrada Díaz-Santos
authors: María Antonia
authors: MA
authors: Maganto Villamiel
authors: Concepción
authors: C
authors: Merino Cáceres
authors: José Manuel
authors: JM
authors: Ribera Casado
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010343:Patient Admission