title: Health status of UK care home residents: a cohort study.
abstract: BACKGROUND
  UK care home residents are often poorly served by existing healthcare arrangements. Published descriptions of residents' health status have been limited by lack of detail and use of data derived from surveys drawn from social, rather than health, care records.
  
  
  OBJECTIVE
  to describe in detail the health status and healthcare resource use of UK care home residents
  
  
  METHODS
  a 180-day longitudinal cohort study of 227 residents across 11 UK care homes, 5 nursing and 6 residential, selected to be representative for nursing/residential status and dementia registration.
  
  
  METHODS
  Barthel index (BI), Mini-mental state examination (MMSE), Neuropsychiatric index (NPI), Mini-nutritional index (MNA), EuroQoL-5D (EQ-5D), 12-item General Health Questionnaire (GHQ-12), diagnoses and medications were recorded at baseline and BI, NPI, GHQ-12 and EQ-5D at follow-up after 180 days. National Health Service (NHS) resource use data were collected from databases of local healthcare providers.
  
  
  RESULTS
  out of a total of 323, 227 residents were recruited. The median BI was 9 (IQR: 2.5-15.5), MMSE 13 (4-22) and number of medications 8 (5.5-10.5). The mean number of diagnoses per resident was 6.2 (SD: 4). Thirty per cent were malnourished, 66% had evidence of behavioural disturbance. Residents had contact with the NHS on average once per month.
  
  
  CONCLUSIONS
  residents from both residential and nursing settings are dependent, cognitively impaired, have mild frequent behavioural symptoms, multimorbidity, polypharmacy and frequently use NHS resources. Effective care for such a cohort requires broad expertise from multiple disciplines delivered in a co-ordinated and managed way.
authors.affiliation: Division of Rehabilitation and Ageing, University of Nottingham, Medical School, Queens Medical Centre, Room B98, Nottingham NG7 2UH, UK.
authors.forename: Adam Lee
authors.initials: AL
authors.lastname: Gordon
authors.forename: Matthew
authors.initials: M
authors.lastname: Franklin
authors.forename: Lucy
authors.initials: L
authors.lastname: Bradshaw
authors.forename: Pip
authors.initials: P
authors.lastname: Logan
authors.forename: Rachel
authors.initials: R
authors.lastname: Elliott
authors.forename: John R F
authors.initials: JR
authors.lastname: Gladman
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003695:Delivery of Health Care; D005260:Female; D015577:Geriatric Assessment; D015276:Health Care Rationing; D006295:Health Resources / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006707:Homes for the Aged; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000453:epidemiology; D008603:Mental Health; D009483:Neuropsychological Tests; D009735:Nursing Homes; D015596:Nutrition Assessment; D009752:Nutritional Status; D019338:Polypharmacy; D013222:State Medicine; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
keywords: cohort studies; health resources; health status; homes for the aged; nursing homes; older people