title: Residential aged care: the de facto hospice for New Zealand's older people.
abstract: OBJECTIVE
  To describe short-term mortality among residential aged care (RAC) residents in Auckland, New Zealand.
  
  
  METHODS
  Prospective follow-up, 6828 residents (median age 86 years, 69.8% women) from census-type survey (10/9/2008); 152 facilities. Mortality data from central sources.
  
  
  RESULTS
  Eight hundred and sixty-one (12.6%) died by 6 months. Survival related to RAC length of stay before the survey: those resident <1 month (subgroup, n = 380) having 80.0% survival, 1-6 months 83.2% and >6 months 87.4% (P < 0.0001). In those admitted to private hospital from acute hospital (n = 104 of the subgroup of 380), 6-month mortality was 36.5% (P < 0.0001 vs other 'short stayers'). Significant mortality predictors were: private hospital admission from acute hospital (hazard ratio (HR) = 2.02), unscheduled GP visit during the prior 2 weeks (HR = 1.90), personal care disability (HR = 1.90) and acute hospital admission number during the previous 2 years (≥3; HR = 5.40).
  
  
  CONCLUSIONS
  RAC mortality (especially post admission) is high. Training and resource in the sector should reflect this.
authors: Freemasons' Department of Geriatric Medicine, University of Auckland, Auckland, New Zealand.
authors: Martin J
authors: MJ
authors: Connolly
authors: Joanna B
authors: JB
authors: Broad
authors: Michal
authors: M
authors: Boyd
authors: Ngaire
authors: N
authors: Kerse
authors: Merryn
authors: M
authors: Gott
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D019352:Censuses; D005260:Female; D019538:Health Care Surveys; D006707:Homes for the Aged / Q000639:trends*; D017051:Hospice Care / Q000639:trends*; D006738:Hospices / Q000639:trends*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D009520:New Zealand; D009735:Nursing Homes / Q000639:trends*; D010166:Palliative Care / Q000639:trends*; D010343:Patient Admission / Q000639:trends; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
keywords: home for older people; mortality; nursing home; older people; palliative care