Resident and Facility Factors Associated with Hospital Visits in Residential Care and Assisted Living Settings: Results from the National Survey of Residential Care Facilities (S728)

Abstract

•Describe the rates of hospital visits and associated resident and facility factors in residential care and assisted living settings.•Explain the need for additional palliative care research and practice in residential care and assisted living settings. In residential care and assisted livings (RC/ALs), hospital visits are distressing for residents, families, and staff. RC/AL residents are at high risk for hospitalization, yet little research investigates factors related to hospitalization in representative samples. This study investigates RC/AL resident and facility factors that relate to general hospital visits for reasons other than stroke, heart attack, or fracture. This study included 8,055 residents (Mage = 79.20, SD = 8.02) from the 2010 National Survey of Residential Care Facilities. Most were white (92%) and female (68%), 24% used Medicaid. The primary outcome was general hospital visits (i.e., overnight stay or emergency department visit). Independent variables included resident demographics, health, change in mental status, social support, and facility characteristics (i.e., size, ownership, specialized care, and surrounding area). In the previous year, 2,777 (35%) residents had a general hospital visit and 457 (6%) were hospitalized on three or more occasions. A logistic regression revealed length of stay less than 6 months; greater ADL assistance; cardiac, pulmonary, and emotional co-morbidities; and living in a small facility (less than 10 total residents) significantly increased risk of general hospital visits at a significance level of .001. Facility size was the strongest predictor in the model (OR = 1.34). Regarding health, 73% of hospitalized residents had cardiac, 19% had pulmonary, 44% had mental health, and 55% had neurological comorbidities. Residents of RC/AL settings evidence high rates of general hospital visits, particularly residents of small facilities and those with cardiac conditions.