From: Clinical predictors of protracted length of stay in Ontario Complex Continuing Care hospitals
Overall | Community Discharge | LTC Discharge | |||||
---|---|---|---|---|---|---|---|
Adjusted Odds Ratio (95% CI) | P-Value | Adjusted Odds Ratio (95% CI) | P-Value | Adjusted Odds Ratio (95% CI) | P-Value | ||
Demographics | |||||||
Female (ref = male) | 0.90 (0.85–0.96) | < 0.01 | 0.90 (0.83–0.97) | 0.01 | 1.00 (0.90–1.12) | 0.96 | |
Age (ref = 0–64) | 65–74 | 0.68 (0.61–0.75) | <.0001 | 0.69 (0.62–0.77) | <.0001 | 0.52 (0.44–0.62) | <.0001 |
75–84 | 0.60 (0.55–0.66) | <.0001 | 0.51 (0.46–0.57) | <.0001 | 0.38 (0.33–0.44) | <.0001 | |
85–94 | 0.52 (0.47–0.58) | <.0001 | 0.43 (0.38–0.49) | <.0001 | 0.30 (0.26–0.36) | <.0001 | |
95+ | 0.56 (0.46–0.69) | <.0001 | 0.29 (0.20–0.41) | <.0001 | 0.35 (0.25–0.49) | <.0001 | |
Clinical Scales | |||||||
ADL Hierarchy Scale (ref = 0) | 1–2 | 1.27 (1.08–1.50) | < 0.01 | 1.59 (1.30–1.94) | <.0001 | 1.36 (0.99–1.87) | 0.06 |
3–4 | 2.11 (1.78–2.49) | <.0001 | 3.01 (2.46–3.68) | <.0001 | 1.76 (1.28–2.42) | 0.0005 | |
5–6 | 2.09 (1.76–2.48) | <.0001 | 2.73 (2.22–3.36) | <.0001 | 1.87 (1.35–2.59) | 0.0002 | |
Cognitive performance scale (ref = 0) | 1–2 | 1.33 (1.21–1.46) | <.0001 | 1.08 (0.98–1.19) | 0.12 | 0.94 (0.80–1.12) | 0.51 |
3+ | 1.60 (1.46–1.75) | <.0001 | 1.23 (1.11–1.37) | 0.0001 | 0.80 (0.67–0.94) | 0.008 | |
CHESS [1] (ref = 0) | 1–2 | 0.72 (0.66–0.77) | <.0001 | 0.74 (0.67–0.81) | <.0001 | 0.72 (0.63–0.82) | <.0001 |
3+ | 0.62 (0.57–0.69) | <.0001 | 0.65 (0.57–0.74) | <.0001 | 0.62 (0.53–0.73) | <.0001 | |
Pressure ulcer risk scale (ref = 0) | 1–2 | 1.06 (0.95–1.17) | 0.28 | 1.21 (1.06–1.38) | 0.006 | 1.08 (0.91–1.29) | 0.38 |
3 | 1.33 (1.18–1.50) | <.0001 | 1.72 (1.47–2.00) | <.0001 | 1.21 (0.98–1.48) | 0.08 | |
4–5 | 1.49 (1.31–1.70) | <.0001 | 2.07 (1.75–2.45) | <.0001 | 1.28 (1.03–1.59) | 0.03 | |
5+ | 2.00 (1.56–2.56) | <.0001 | 2.95 (2.14–4.06) | <.0001 | 1.54 (1.02–2.32) | 0.04 | |
Aggressive behaviour scale (ref = 0) | 1–4 | 1.32 (1.16–1.49) | <.0001 | ||||
5+ | 1.81 (1.50–2.17) | <.0001 | |||||
Health service utilization | |||||||
Hospital stays [2] (ref = 0) | 1 stay | 0.81 (0.75–0.87) | <.0001 | 0.80 (0.72–0.88) | <.0001 | 0.78 (0.69–0.89) | 0.0002 |
2+ stays | 0.66 (0.59–0.73) | <.0001 | 0.63 (0.55–0.72) | <.0001 | 0.63 (0.52–0.75) | <.0001 | |
Emergency department visits [2] (ref = 0) | 1 visit | 0.85 (0.79–0.92) | <.0001 | 0.95 (0.86–1.04) | 0.23 | 0.77 (0.68–0.87) | <.0001 |
2+ visits | 0.70 (0.60–0.81) | <.0001 | 0.77 (0.64–0.93) | 0.006 | 0.65 (0.51–0.83) | 0.0006 | |
Previous nursing home admission (ref = no) | 0.82 (0.72–0.92) | < 0.01 | 0.63 (0.52–0.76) | <.0001 | |||
Health conditions | |||||||
Hemiplegia (ref = not present) | 1.40 (1.27–1.54) | <.0001 | 2.27 (2.04–2.53) | <.0001 | 1.22 (1.05–1.43) | 0.01 | |
Quadriplegia (ref = not present) | 1.38 (1.07–1.79) | 0.01 | 2.79 (1.73–4.49) | <.0001 | |||
Traumatic brain injury (ref = not present) | 1.67 (1.38–2.02) | <.0001 | 1.92 (1.52–2.42) | <.0001 | 1.82 (1.36–2.44) | <.0001 | |
Cancer (ref = not present) | 0.78 (0.71–0.86) | <.0001 | 0.80 (0.71–0.90) | 0.0002 | |||
Aphasia (ref = not present) | 1.50 (1.34–1.68) | <.0001 | 1.22 (1.05–1.43) | 0.01 | 1.89 (1.60–2.23) | <.0001 | |
Antibiotic resistant infection (ref = not present) | 1.43 (1.28–1.59) | <.0001 | 1.55 (1.36–1.76) | <.0001 | |||
HIV infection (ref = not present) | 2.34 (1.48–3.69) | 0.0003 | 2.95 (1.87–4.66) | <.0001 | |||
Pneumonia (ref = not present) | 0.82 (0.72–0.94) | 0.004 | 0.73 (0.61–0.86) | 0.0003 | |||
Unsteady gait (ref = not present) | 0.74 (0.69–0.79) | <.0001 | 0.70 (0.65–0.76) | <.0001 | 0.79 (0.71–0.88) | <.0001 | |
Therapies | |||||||
Feeding tube (ref = no) | 1.56 (1.37–1.78) | <.0001 | 1.42 (1.20–1.68) | <.0001 | 1.87 (1.53–2.29) | <.0001 | |
Dialysis (ref = no) | 1.54 (1.24–1.90) | <.0001 | 1.57 (1.23–1.99) | 0.0003 | |||
Psychological therapy [3] (ref = no) | 1.64 (1.52–1.78) | <.0001 | 1.47 (1.33–1.62) | <.0001 | 1.70 (1.49–1.95) | <.0001 | |
Tracheostomy, ventilator or respirator (ref = no) | 1.89 (1.50–2.39) | <.0001 | 2.11 (1.63–2.73) | <.0001 | 2.07 (1.35–3.18) | 0.0008 | |
Discharge potential | |||||||
Desire to return to community (ref = no) | 0.42 (0.39–0.45) | <.0001 | 0.44 (0.40–0.49) | <.0001 | 0.58 (0.51–0.65) | <.0001 | |
Support person positive towards discharge (ref = no) | 0.63 (0.58–0.68) | <.0001 | 0.54 (0.48–0.61) | <.0001 | 0.77 (0.68–0.87) | <.0001 | |
C Statistic | 0.76 | 0.77 | 0.74 |