Change over time in characteristics and survival of residents newly admitted to nursing homes: an analysis of health insurance claims data from 2011 to 2020 in Germany.

IF 3.5 2区 社会学 Q1 GERONTOLOGY
Hannes Jacobs, Stephanie Stiel, Anna Völkel, Tanja Schleef, Birte Burger, Jona Theodor Stahmeyer, Kathrin Wandscher, Anna Levke Brütt, Falk Hoffmann
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Abstract

Background: Studies on changes in characteristics and survival of nursing home residents (NHRs) are rare. Therefore, this study aims to analyze ten-year trends in newly admitted German NHRs.

Methods: For this retrospective cohort study, claims data of a regional German health insurance fund was used to identify all residents aged 65 years and older newly admitted to a nursing home between 2011 and 2020 (with a follow-up period ending on December 31, 2021). Characteristics of NHRs were analysed descriptively and stratified by 5 two-year cohorts. Survival times and mortality were assessed by applying the Kaplan-Meier-method and a cox regression was used.

Results: A total of 113,929 residents were newly admitted between 2011 and 2020 (69% female; mean age 83.8 years). Over the years, the proportion of men and the mean age slightly increased. Prevalence of dementia remained nearly stable (45-48%) while cancer prevalence raised from 30 to 37%. Overall, median survival time decreased from 745 days in 2011/2012 to 615 days in 2019/2020. Survival times in residents with dementia decreased significantly (median survival from 790 to 651 days) while it remained nearly unchanged in cancer patients (from 444 to 410 days).

Conclusions: We found that survival after nursing home admission decreased in Germany from 2011 to 2020, which was accompanied by shorter survival in residents with dementia and by an increasing proportion of those with cancer, who already experience higher mortality. There is a growing need to integrate palliative care in nursing homes and to also provide appropriate care for older patients with cancer outside nursing homes.

Abstract Image

新入住养老院的居民的特征和存活率随时间的变化:对德国2011年至2020年健康保险索赔数据的分析
背景:关于养老院居民(NHRs)特征及生存变化的研究很少。因此,本研究旨在分析新入职的德国nhr的十年趋势。方法:在这项回顾性队列研究中,使用德国区域健康保险基金的索赔数据来确定2011年至2020年期间新入住养老院的所有65岁及以上的居民(随访期截止到2021年12月31日)。通过5个为期两年的队列对nhr的特征进行描述性分析和分层。生存时间和死亡率采用kaplan - meier法评估,并采用cox回归。结果:2011年至2020年,共新入院113929人,其中女性占69%;平均年龄83.8岁)。多年来,男性的比例和平均年龄略有增加。痴呆症的患病率几乎保持稳定(45-48%),而癌症患病率则从30%上升到37%。总体而言,中位生存时间从2011/2012年的745天下降到2019/2020年的615天。痴呆症患者的生存时间显著下降(中位生存期从790天降至651天),而癌症患者的生存时间几乎保持不变(从444天降至410天)。结论:我们发现,从2011年到2020年,德国养老院入院后的生存率下降,痴呆患者的生存率缩短,癌症患者的生存率增加,而癌症患者的死亡率已经很高了。越来越需要将姑息治疗纳入养老院,并为养老院以外的老年癌症患者提供适当的护理。
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来源期刊
CiteScore
6.50
自引率
7.90%
发文量
72
期刊介绍: The European Journal of Ageing: Social, Behavioural and Health Perspectives is an interdisciplinary journal devoted to the understanding of ageing in European societies and the world over. EJA publishes original articles on the social, behavioral and population health aspects of ageing and encourages an integrated approach between these aspects. Emphasis is put on publishing empirical research (including meta-analyses), but conceptual papers (including narrative reviews) and methodological contributions will also be considered. EJA welcomes expert opinions on critical issues in ageing. By stimulating communication between researchers and those using research findings, it aims to contribute to the formulation of better policies and the development of better practice in serving older adults. To further specify, with the term ''social'' is meant the full scope of social science of ageing related research from the micro to the macro level of analysis. With the term ''behavioural'' the full scope of psychological ageing research including life span approaches based on a range of age groups from young to old is envisaged. The term ''population health-related'' denotes social-epidemiological and public health oriented research including research on functional health in the widest possible sense.
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