Background: Nursing home residents are potentially some of the most vulnerable health service users; however, there is limited internationally comparable data on the health of this population. Basic epidemiological data can show how residents use nursing homes, and inform future service provision to serve an ageing population.
Aims: This analysis aims to explore factors associated with shorter lengths of stay before death in nursing homes across six European countries.
Methods: The PACE study, a mortality followback survey design. This analysis used a subset of data collected on residents who died in nursing homes providing onsite nursing care and offsite physician care across the six countries. Data on all residents who died in a retrospective three month period were collected from nursing home staff and the residents’ relative. Cox proportional hazard modelling was used to model the data and is reported as hazard ratios (HR).
Results: Analysis was conducted on 869 residents across the six countries. Admission to a nursing home at older ages (HR 1.05), being male (HR 1.49), being either married or in a civil partnership (HR 1.56) or having a cancer diagnosis (HR 1.50) were significant risk factors for shorter lengths of stay before death. Admission from either a hospital (HR 1.78) or another nursing home (HR 1.78) and residence in a private, non-profit owned nursing home compared to a public, non-profit owned nursing home (HR 1.37) were also associated with shorter lengths of stay. Comparing between countries, Italy (HR 1.58), Poland (HR 1.68), and England (HR 1.66) had significantly shorter lengths of stay than Belgium (ref), the Netherlands (HR 1.17) and Finland (HR 1.23).
Conclusions: This analysis highlights variation in nursing home use across residents. The relationship between experiences prior to nursing home admission, the availability of other types of long-term care and their influence on subsequent length of stay requires further research.