title: Three Different Outcomes in Older Community-dwelling Patients Receiving Intermediate Care in Nursing Home after Acute Hospitalization.
abstract: OBJECTIVE
  To evaluate the recovery and outcome of older communitydwelling patients admitted to intermediate care (IC) in nursing homes after acute hospitalization, and to compare patients who were able and unable to return directly to their own homes.
  
  
  METHODS
  Prospective, observational, cohort study conducted between June 2011 and 2014.
  
  
  METHODS
  A 19- bed IC unit in a nursing home with increased multidisciplinary staffing.
  
  
  METHODS
  A total of 961 community-dwelling patients, ≥70 years of age, considered to have a rehabilitation potential and no major cognitive impairment or delirium, transferred from internal medicine, cardiac, pulmonary and orthopaedic hospital departments.
  
  
  METHODS
  Demographic data, clinical information, comprehensive geriatric assessment (CGA), discharge destination and length of stay. Residence status and mortality 1 month, 2 months, 3 months, and 6 months after discharge from the hospital.
  
  
  RESULTS
  The trajectory of recovery was divided into 3 groups: 1) Rapid recovery, able to return home after median 14 days in IC (n=785, 82%); 2) Slow recovery, requiring additional transfer to other nursing home after IC, but still able to return home within 2 months (n=106, 11%). 3) Poor recovery, requiring transfer to other nursing home after IC and still in a nursing home or dead at 2 months (n=66, 7%). Significant different clinical characteristics were demonstrated between the patients in the 3 groups. After 6 months, the recovery of patients with rapid or slow recovery was similar, 87% were living at home, compared to only 20% of the patients with poor recovery. In multiple logistic regression analysis, slow or poor recovery was significantly associated with low scores on the Barthel index and orthopaedic admission diagnosis.
  
  
  CONCLUSIONS
  Although the majority of patients selected for treatment in the IC unit were able to recover and return home, a group of patients needed extra time, up to 2 months, to recover and another group had a poor chance of recovering and returning home. Different caring pathways for different patient groups may be considered in the PAC setting.
authors.affiliation: Jenny Foss Abrahamsen, Kavli Research Centre for Geriatrics and Dementia, Haraldsplass Deaconess Hospital, Ulriksdal 8, Bergen, 5009, Norway, +47 99514977, jennyfossabrahamsen@gmail.com.
authors.forename: J F
authors.initials: JF
authors.lastname: Abrahamsen
authors.forename: C
authors.initials: C
authors.lastname: Haugland
authors.forename: R M
authors.initials: RM
authors.lastname: Nilsen
authors.forename: A H
authors.initials: AH
authors.lastname: Ranhoff
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015577:Geriatric Assessment; D006699:Home Care Services; D006748:Hospital Departments; D006757:Hospital Units; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007380:Intermediate Care Facilities; D007902:Length of Stay; D009735:Nursing Homes; D010351:Patient Discharge; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome