Impact of nursing home admission on health care use and disease status elderly dependent people one year before and one year after skilled nursing home admission based on 2012-2013 SNIIRAM data.

ABSTRACT

BACKGROUND: The aim of this study was to compare disease status and health care use 1 year before and 1 year after skilled nursing home (SNH) admission. METHODS: People over the age of 65 years admitted to SNH during the first quarter of 2013, covered by the national health insurance general scheme (69% of the population of this age), and still alive 1 year after admission were identified (n = 14,487, mean age 86 years, women 76%). Their reimbursed health care was extracted from the Système National d'Information Interrégimes de l'Assurance Maladie (SNIIRAM) [National Health Insurance Information System]. RESULTS: One year after nursing home admission, the most prevalent diseases were cardiovascular/neurovascular diseases and neurodegenerative diseases (affecting 45% and 40% of people before admission vs 51% and 53% after admission, respectively). Physical therapy use increased (43% vs 64% of people had at least one physical therapy session during the year, with an average of 47 vs 84 sessions/person during the year), while specialist consultations decreased (29% of people consulted an ophthalmologist at least once during the year before admission vs 25% after admission; 27% vs 21% consulted a cardiologist). Hospitalization rates were lower during the year following institutionalization (75% vs 40% of people were hospitalized at least once during the year), together with a lower emergency admission rate and a higher day admission rate. CONCLUSIONS: Analysis of the new French reimbursement database specific to SNH shows that nursing home admission is associated with a reduction of some forms of outpatient care and hospitalizations.