State variation in nursing home mortality outcomes according to do-not-resuscitate status.
J Gerontol A Biol Sci Med Sci
; 55(4): M215-20, 2000 Apr.
Article
en En
| MEDLINE
| ID: mdl-10811151
ABSTRACT
BACKGROUND:
This study compares mortality outcomes of Medicaid-reimbursed nursing home residents with and without do-not-resuscitate (DNR) orders in two diverse states.METHODS:
We used 1994 Minimum Data Set Plus (MDS+) information on 3215 nursing home residents from two states. We used Kaplan-Meier analyses to examine unadjusted mortality among those with and without DNR orders across states. We used a proportional hazard regression with main and interaction variables to model the likelihood of survival in the nursing home.RESULTS:
Approximately 27% of nursing home residents with DNR orders in State A die within the year, and approximately 40% of nursing home residents with DNR orders in State B die within the year. Regression results indicate that neither having a DNR order nor state of residence were independently associated with mortality. However, residing in State B and having a DNR order was associated with an increased risk of mortality compared with all others in the sample (risk ratio = 1.73; 95% confidence interval = 1.09, 2.75).CONCLUSION:
This study demonstrates that DNR orders are associated with varying mortality across states. Future research is needed to identify the reasons why state level differences exist.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Órdenes de Resucitación
/
Casas de Salud
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
Aspecto:
Ethics
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Gerontol A Biol Sci Med Sci
Asunto de la revista:
GERIATRIA
Año:
2000
Tipo del documento:
Article
País de afiliación:
Estados Unidos