Background: As the population ages, it is likely that the number of older adults admitted to nursing homes (NHs) will increase. NH residents are more likely to have multiple comorbidities and have a greater use of healthcare services than older adults living in the community. It is unclear how length of stay in a NH varies between residents and across NH facilities.
Aims: This study aims to provide a comprehensive, up to date summary of published research exploring factors associated with the length of stay of older adult's residing in NHs.
Methods: A systematic review of published, peer reviewed and grey literature. Electronic searches were conducted using MEDLINE, EMBASE, PsycINFO, CINAHL, Proquest, the Cochrane Library, Web of Science, the Campbell Library, SCOPUS and Social Care Online. Papers were included if they were observational,
epidemiological studies exploring the influence of at least two predictive variables on either length of stay before death or mortality in adults aged over 65 years residing in NHs.
Results: The electronic searches identified over 11,000 papers, of which 56 met the initial inclusion criteria. The findings suggest that increased age, being male, functional dependence in ADLs, cognitive impairment and urinary incontinence may be related to increased mortality. Contact with primary care services, hospital admissions, medication use, placement from hospitals and residence in facilities with nursing may also be associated with decreased survival.
Conclusions: The predictive characteristics identified could facilitate recognition of residents approaching end of life and inform treatment choices. Although the value of using length of stay as an indicator of quality of care is debatable, variation within and across NHs warrants further attention. Internationally comparable data collected by studies such as the PACE study could be used to further research in this area.