A Census-based longitudinal study of variations in survival amongst residents of nursing and residential homes in Northern Ireland

摘要

Background: despite the intensive services provided to residents of care homes, information on death rates is not routinelynavailable for this population in the UK.nObjective: to quantify mortality rates across the care home population of Northern Ireland, and assess variation by type ofncare home and resident characteristics.nDesign: a prospective, Census-based cohort study, with 5-year follow-up.nParticipants: all 9,072 residents of care homes for people aged 65 and over at the time of the 2001 census with a specialnemphasis on the 2,112 residents admitted during the year preceding census day.nMeasurements: age, sex, self-reported health, marital status, residence (not in care home, residential home, dual registerednhome, nursing home), elderly mentally infirm care provision.nResults: themedian survival among nursing home residents was 2.33 years (95% CI 2.25–2.59), for dual registered homes 2.75n(95% CI 2.42–3.17) and for residential homes 4.51 (95% CI 3.92–4.92) years. Age, sex and self-reported health showed weakernassociations in the sicker populations in nursing homes compared to those in residential care or among the non-institutionalised.nConclusions: the high mortality in care homes indicates that places in care homes are reserved for the most severely ill andndependent. Death rates may not be an appropriate care quality measure for this population, but may serve as a useful adjunctnfor clinical staff and the planning of care home provision.