Home care patients in four Nordic capitals – predictors of nursing home admission during one-year followup

Figures & data

Table 1 Background data, health service utilization and care burden stress in the participating sites

	Copenhagen	Reykjavik	Oslo	Stockholm	Total
	n = 469	n = 405	n = 388	n = 246	n = 1508
Agea (years, mean, SD)	84.4 (6.8)	81.7 (6.6)	83.9 (6.3)	84.1 (6.8)	83.5 (6.7)
Female	79	74	72	73	75
Living alone	76	68	74	80	74
Homeboundb	28	22	28	24	27
Hospitalization in last 90 days	13	13	13	14	13
Nursing procedures	47	66	72	41	58
Nursec (days per week, mean, SD)	1.29 (2.1)	1.5 (1.8)	4.2 (3.0)	0.5 (1.1)	2.2 (2.7)
Care burden stress	8	4	8	5	6
Better off somewhere else	13	18	8	9	12
MAPLed ≥ 4: high/very high priority (0–5)	15	16	16	12	15
Participations’ rate	90	97	93	62	74
Nursing home	8	8	16	9	10
Dead	10	6	17	23	13

Notes: Data presented as percentage unless otherwise indicated.

a Male = 82.1 (6.9), Female = 84.0 (6.6);

b “No days out of the house or building during the last week” or “needed extensive assistance for outside locomotion”.

c Visiting nurse n = 1026;

d MAPLe (Method for Assigning Priority Levels) client’s eligibility for admission to a nursing home (Scale 0–5).

Abbreviation: SD, standard deviation.

Table 2 Characteristics and clinical features associated with nursing home admission during the 12-month followup

Yes/No	Overall n (%)	NHA		P-value	Odds ratio
		Yes n (%)	No n (%)		(95% confidence intervals)
Demographic characteristics of patients
Female	1129 (74.9)	113 (10.0)	1016 (90.0)	0.761	0.94 (0.64–1.38)
Male	379 (25.1)	40 (10.6)	339 (89.4)	0.761	1.06 (0.75–1.55)
Age 85 years and over	662 (43.9)	88 (13.3)	574 (86.7)	0.001	1.84 (1.31–2.58)
Lived alone	1115 (73.9)	103 (9.2)	1012 (90.8)	0.05	0.70 (0.48–1.00)
Diagnosis
Alzheimer’s/dementia	174 (11.5)	28 (16.1)	146 (83.9)	0.006	1.86 (1.19–2.89)
Parkinson’s disease	30 (2.0)	10 (33.3)	20 (66.7)	0.001	4.67 (2.14–10.17)
Arthritis	492 (32.6)	64 (13.0)	428 (87.0)	0.01	1.56 (1.11–2.19)
Symptoms and need of assistance
CPS scale ≥ 1 (0–6)	484 (32.1)	91 (18.8)	393 (81.2)	0.001	3.59 (2.55–5.07)
CPS scale ≥ 4 (0–6)	50 (3.3)	16 (32.0)	34 (68.0)	0.001	4.54 (2.54–8.43)
Unstable conditiona	244 (16.2)	46 (18.9)	198 (81.1)	0.01	2.51 (1.72–3.66)
ADL scale ≥ 1 (0–8)	637 (42.3)	98 (15.4)	539 (84.6)	0.001	2.69 (1.90–3.81)
IADL scale ≥ 4 (0–7)	751 (49.8)	128 (17.0)	623 (83.0)	0.001	6.02 (3.87–9.36)
MAPLeb scale ≥ 4 (0–5)	220 (14.6)	46 (20.9)	174 (79.1)	0.001	2.29 (2.00–4.27)
Dizziness	372 (24.7)	51 (13.7)	321 (86.3)	0.009	1.61 (1.13–2.31)
Falls (last 90 days)	342 (22.7)	52 (15.2)	291 (84.8)	0.001	1.88 (1.31–2.70)
Vision/hearing problems	620 (41.1)	103 (16.6)	517 (83.4)	0.001	3.34 (2.34–4.76)
Incontinencec	638 (42.3)	92 (14.4)	546 (85.6)	0.001	2.24 (1.59–3.14)
Medications
Antidepressants	305 (20.3)	46 (15.1)	259 (84.9)	0.001	1.83 (1.26–2.66)
Health status
Self-rated bad health	492 (32.6)	64 (13.0)	428 (87.0)	0.01	1.56 (1.11–2.19)
Homebound	390 (25.9)	74 (19.0)	316 (81.0)	0.001	3.08 (2.19–3.33)
Better off in another environment	185 (12.3)	44 (23.8)	141 (76.2)	0.001	3.48 (2.35–5.14)
Formal and informal care
Nursing procedures	867 (57.5)	130 (15.0)	737 (85.0)	0.001	4.74 (3.00–7.48)
Hospitalized last 90 days	200 (13.3)	32 (16.0)	168 (84.0)	0.003	1.87 (1.23–2.85)
Prior LTCF	106 (7.0)	23 (21.7)	83 (78.3)	0.001	2.71 (1.65–4.45)
Caregiver stress	99 (14.4)	21 (21.2)	78 (78.8)	0.014	4.96 (2.14–3.37)
Country-specific site
Copenhagen	469 (31.1)	38 (8.1)	431 (91.9)	0.077	0.71 (0.48–1.04)
Reykjavik	405 (26.9)	32 (7.9)	373 (92.1)	0.080	0.70 (0.46–1.46)
Oslo	388 (25.7)	62 (16.0)	326 (84.0)	0.001	2.15 (1.52–3.04)
Stockholm	246 (16.3)	21 (8.7)	225 (91.5)	0.361	0.80 (0.49–1.29)

Notes:

a Has conditions or diseases that make cognition, ADL, mood or behaviour patterns unstable (fluctuations, precarious, or deteriorating;

b MAPLe) client’s eligibility for admission to a (Scale 0–5);

c Bowel or bladder.

Abbreviations: ADL, activities of daily living; CPS, Cognitive Performance Scale; IADL, instrumental activities of daily living; LTCF, long time care facility; MAPLe, Method for Assigning Priority Levels.

Table 3 Binary logistic regression analysis with forward selection of variables: Nursing home admission during the 12-month followup

Independent variable	Adjusted odds ratio	95% CI	P-value
Aged ≥ 85	1.73	1.06–2.80	0.029
IADL ≥ 4 (scale 0–7)	2.25	1.18–4.28	0.014
CPS ≥ 1 (scale 0–6)	1.68	1.01–2.80	0.046
Nursing procedures	3.67	1.72–7.82	0.001
Homebound	1.80	1.08–2.99	0.023
Incontinent (bowel/bladder)	1.67	1.03–2.72	0.040
Better off in another environment	2.09	1.11–3.93	0.022

Notes: Wald χ² (7) = 81,640; P < 0.001; Nagelkerke R² = 0.25.

Abbreviations: CI, confidence interval; CPS, ; IADL, .