title: Correlates of a "do not hospitalize" designation: in a sample of frail nursing home residents in Vancouver.
abstract: OBJECTIVE
  To explore what nursing home resident demographic, clinical, functional, and health services utilization characteristics influence a "do not hospitalize" designation.
  
  
  METHODS
  Historical cohort study.
  
  
  METHODS
  Vancouver, BC.
  
  
  METHODS
  Extended care residents in 2 hospital-based and 4 free-standing nursing homes who died between 2001 and 2007.
  
  
  METHODS
  The designation of "do not hospitalize" on a resident's chart.
  
  
  RESULTS
  Continuity of family physician care from admission to death (adjusted hazard ratio [AHR] 2.16, 95% confidence interval [CI] 1.33 to 3.49), a sudden and unexpected death (AHR 0.43, 95% CI 0.25 to 0.73), and age (AHR 1.02, 95% CI 1.01 to 1.02) were independently associated with a "do not hospitalize" designation.
  
  
  CONCLUSIONS
  The greater than 2-fold positive association of continuity of family physician care with a "do not hospitalize" designation is an interesting addition to the literature on how continuity of physician care matters.
authors.affiliation: Centre for Clinical Epidemiology & Evaluation, Department of Family Practice, Room 713, 828 West 10th, Vancouver, BC V5Z 1L8. mrgret@interchange.ubc.ca
authors.forename: Margaret
authors.initials: M
authors.lastname: McGregor
authors.forename: Dan
authors.initials: D
authors.lastname: Pare
authors.forename: Areta
authors.initials: A
authors.lastname: Wong
authors.forename: Michelle B
authors.initials: MB
authors.lastname: Cox
authors.forename: Penny
authors.initials: P
authors.lastname: Brasher
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D001955:British Columbia; D015331:Cohort Studies; D015897:Comorbidity; D003266:Continuity of Patient Care; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D010343:Patient Admission; D010360:Patient Transfer; D010817:Physician-Patient Relations; D016016:Proportional Hazards Models; D014600:Utilization Review