Background: The profile of nursing home residents across Europe is changing; residents are older, frailer and likely to have comorbidities. An understanding of anticipated length of stay is important in developing care plans, healthcare resource allocation and informing the decisions of residents and their relatives. Length of stay before death in European nursing homes is not well understood.
Aims: This paper aims to explore resident and facility characteristics associated with length of stay in nursing homes across six European countries: Belgium, England, Finland, Italy, the Netherlands and Poland.
Methods: Data from the PACE study, a mortality followback survey comparing the
effectiveness of health care systems with and without formal palliative care
structures. All residents who died in a three month period residing in nursing homes across six European countries during 2015 were included. Data on the residents was collected from the nursing home, the general practitioner and relative. Resident characteristics previously identified as possibly being related to length of stay, including age, gender, diagnoses, physical functioning, contact with health service and facility characteristics were included in a prediction model. Length of stay was calculated from date of admission to date of death.
Results: Data was collected using questionnaires on 1,707 residents in 322 nursing homes. The mean length of stay was 31.0 months (SD 43.3) (Belgium 40.0 (SD 46.7), England 24.4 (SD 32.2), Finland 28.2 (SD 36.3), Italy 27.0 (SD 47.4), Netherlands 34.0 (SD 36.7), Poland 28.7 (SD 50.1). Within one year of admission, 45% of residents had died, and within five years of admission, 84% of residents had died. Factors associated with shorter lengths of stay included being male, history of stroke and shortness of breath.
Conclusions: The identification of shorter stay residents is possible from data collected by nursing homes, allowing the prediction of anticipated residence to be made by care staff on admission. Further research is needed on the trajectories of nursing home residents from admission to death.