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Risk of Continued Institutionalization After Hospitalization in Older Adults
James S. Goodwin, Bret T. Howrey, Dong Zhang, Yong‐Fang Kuo. The Journals of Gerontology Series A, 2011-10-03
Topic: Risk, prevention and care in population studies
From 1996 through 2008, 5.55% of hospitalized patients resided in a nursing home 6 months later compared with 0.54% of nonhospitalized control patients. Three quarters of new nursing home placements were precipitated by a hospitalization. Independent risk factors for long-term care placement after hospitalization included advanced age (odds ratio [OR] = 3.56 for age 85-94 vs. 66-74 years), female gender (OR = 1.41), dementia (OR = 6.15), and discharge from the hospital to a skilled nursing facility (SNF; OR = 10.83). Having a primary care physician was associated with reduced odds (OR = 0.75). In the adjusted analyses, risk of institutionalization after hospitalization decreased 4% per year from 1996 to 2008. There were very large geographic variations in rates of long-term care after hospitalization, from 13% in others for patients > 75 years in 2007-2008. Most placements in nursing homes are preceded by a hospitalization followed by discharge to a SNF. Discharge to a SNF is associated with a high risk of subsequent long-term care.
Key findings
- From 1996 through 2008, 5.55% of hospitalized patients resided in a nursing home 6 months later compared with 0.54% of nonhospitalized control patients.
- Three quarters of new nursing home placements were precipitated by a hospitalization.
- Independent risk factors for long-term care placement after hospitalization included advanced age (odds ratio [OR] = 3.56 for age 85-94 vs. 66-74 years), female gender (OR = 1.41), dementia (OR = 6.15), and discharge from the hospital to a skilled nursing facility (SNF; OR = 10.83).
- Having a primary care physician was associated with reduced odds (OR = 0.75).
- In the adjusted analyses, risk of institutionalization after hospitalization decreased 4% per year from 1996 to 2008.
Why it matters
Hospitalized older adults were much more likely to be in a nursing home six months later than nonhospitalized controls, and three quarters of new nursing home placements followed a hospitalization. Dementia, older age, female sex, and discharge to a skilled nursing facility were risk factors for long-term care placement.
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Study details
- Study designretrospective cohort
- Participants762,243
- Effect size5.55%; 0.54%; OR = 1.41
- Evidence strengthModerate
How this study scored 62/100
Published in a peer-reviewed journal, and it is a retrospective cohort study, reconstructed from past records. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The Journals of Gerontology Series A) |
| Journal's citation record | 3 / 4 | The Journals of Gerontology Series A: journal h-index 274 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A retrospective cohort study, reconstructed from past records |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2011 — within 20 year(s) of the newest study here |
| Sample size | 4 / 4 | 762,243 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 115 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 6.8 citations a year over 17 year(s) since 2011 |
| Impact for its field and year | 4 / 6 | Cited 10.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 2 / 4 | Cited 27 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Yong‐Fang Kuo: h-index 76 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | The University of Texas Medical Branch at Galveston: institution h-index 655 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 21968285) |
| Free to read | 2 / 2 | Free to read |
| Total | 62 / 100 | — |
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Read the original
- DOI: 10.1093/gerona/glr171
- PubMed: 21968285
- Original source →
- Free full text: The Journals of Gerontology Series A →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Goodwin, J. S., Howrey, B. T., Zhang, D., & Kuo, Y. (2011). Risk of Continued Institutionalization After Hospitalization in Older Adults. The Journals of Gerontology Series A. https://doi.org/10.1093/gerona/glr171
Vancouver
Goodwin JS, Howrey BT, Zhang D, Kuo Y. Risk of Continued Institutionalization After Hospitalization in Older Adults. The Journals of Gerontology Series A. 2011. doi:10.1093/gerona/glr171. PMID: 21968285.
BibTeX
@article{goodwin2011-21968285,
author = {Goodwin, James S. and Howrey, Bret T. and Zhang, Dong and Kuo, Yong‐Fang},
title = {{Risk of Continued Institutionalization After Hospitalization in Older Adults}},
journal = {The Journals of Gerontology Series A},
year = {2011},
doi = {10.1093/gerona/glr171},
pmid = {21968285},
url = {https://doi.org/10.1093/gerona/glr171}
}
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