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Characteristics of Working-Age Adults With Schizophrenia Newly Admitted to Nursing Homes

dc.contributor.authorHugunin, Julie
dc.contributor.authorYuan, Yiyang
dc.contributor.authorBaek, Jonggyu
dc.contributor.authorClark, Robin E.
dc.contributor.authorRothschild, Anthony J.
dc.contributor.authorLapane, Kate L
dc.contributor.authorUlbricht, Christine M.
dc.date2022-08-11T08:10:37.000
dc.date.accessioned2022-08-23T17:14:39Z
dc.date.available2022-08-23T17:14:39Z
dc.date.issued2021-12-14
dc.date.submitted2022-04-13
dc.identifier.citation<p>Hugunin J, Yuan Y, Baek J, Clark RE, Rothschild AJ, Lapane KL, Ulbricht CM. Characteristics of Working-Age Adults With Schizophrenia Newly Admitted to Nursing Homes. J Am Med Dir Assoc. 2021 Dec 14:S1525-8610(21)01006-9. doi: 10.1016/j.jamda.2021.11.019. Epub ahead of print. PMID: 34919836. <a href="https://doi.org/10.1016/j.jamda.2021.11.019">Link to article on publisher's site</a></p>
dc.identifier.issn1525-8610 (Linking)
dc.identifier.doi10.1016/j.jamda.2021.11.019
dc.identifier.pmid34919836
dc.identifier.urihttp://hdl.handle.net/20.500.14038/47001
dc.description.abstractOBJECTIVES: Persons aged < 65 years account for a considerable proportion of US nursing home residents with schizophrenia. Because they are often excluded from psychiatric and long-term care studies, a contemporary understanding of the characteristics and management of working-age adults (22-64 years old) with schizophrenia living in nursing homes is lacking. This study describes characteristics of working-age adults with schizophrenia admitted to US nursing homes in 2015 and examines variations in these characteristics by age and admission location. Factors associated with length of stay and discharge destination were also explored. DESIGN: This is a cross-sectional study using the Minimum Data Set 3.0 merged to Nursing Home Compare. SETTING AND PARTICIPANTS: This study examines working-age (22-64 years) adults with schizophrenia at admission to a nursing home. METHODS: Descriptive statistics of resident characteristics (sociodemographic, clinical comorbidities, functional status, and treatments) and facility characteristics (ownership, geography, size, and star ratings) were examined overall, stratified by age and by admission location. Generalized estimating equation models were used to explore the associations of age, discharge to the community, and length of stay with relevant resident and facility characteristics. Coefficient estimates, adjusted odds ratios, and 95% CIs are presented. RESULTS: Overall, many of the 28,330 working-age adults with schizophrenia had hypertension, diabetes, and obesity. Those in older age subcategories tended to have physical functional dependencies, cognitive impairments, and clinical comorbidities. Those in younger age subcategories tended to exhibit higher risk of psychiatric symptoms. CONCLUSIONS AND IMPLICATIONS: Nursing home admission is likely inappropriate for many nursing home residents with schizophrenia aged < 65 years, especially those in younger age categories. Future psychiatric and long-term care research should include these residents to better understand the role of nursing homes in their care and should explore facility-level characteristics that may impact quality of care.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=34919836&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://doi.org/10.1016/j.jamda.2021.11.019
dc.subjectSchizophrenia
dc.subjectdelivery of health care
dc.subjectlong-term care
dc.subjectnursing homes
dc.subjectpsychiatric care
dc.subjectEpidemiology
dc.subjectHealth Services Administration
dc.subjectHealth Services Research
dc.subjectPsychiatry and Psychology
dc.subjectUMCCTS funding
dc.titleCharacteristics of Working-Age Adults With Schizophrenia Newly Admitted to Nursing Homes
dc.typeJournal Article
dc.source.journaltitleJournal of the American Medical Directors Association
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/1478
dc.identifier.contextkey28637750
html.description.abstract<p>OBJECTIVES: Persons aged < 65 years account for a considerable proportion of US nursing home residents with schizophrenia. Because they are often excluded from psychiatric and long-term care studies, a contemporary understanding of the characteristics and management of working-age adults (22-64 years old) with schizophrenia living in nursing homes is lacking. This study describes characteristics of working-age adults with schizophrenia admitted to US nursing homes in 2015 and examines variations in these characteristics by age and admission location. Factors associated with length of stay and discharge destination were also explored.</p> <p>DESIGN: This is a cross-sectional study using the Minimum Data Set 3.0 merged to Nursing Home Compare.</p> <p>SETTING AND PARTICIPANTS: This study examines working-age (22-64 years) adults with schizophrenia at admission to a nursing home.</p> <p>METHODS: Descriptive statistics of resident characteristics (sociodemographic, clinical comorbidities, functional status, and treatments) and facility characteristics (ownership, geography, size, and star ratings) were examined overall, stratified by age and by admission location. Generalized estimating equation models were used to explore the associations of age, discharge to the community, and length of stay with relevant resident and facility characteristics. Coefficient estimates, adjusted odds ratios, and 95% CIs are presented.</p> <p>RESULTS: Overall, many of the 28,330 working-age adults with schizophrenia had hypertension, diabetes, and obesity. Those in older age subcategories tended to have physical functional dependencies, cognitive impairments, and clinical comorbidities. Those in younger age subcategories tended to exhibit higher risk of psychiatric symptoms.</p> <p>CONCLUSIONS AND IMPLICATIONS: Nursing home admission is likely inappropriate for many nursing home residents with schizophrenia aged < 65 years, especially those in younger age categories. Future psychiatric and long-term care research should include these residents to better understand the role of nursing homes in their care and should explore facility-level characteristics that may impact quality of care.</p>
dc.identifier.submissionpathqhs_pp/1478
dc.contributor.departmentDepartment of Population and Quantitative Health Sciences
dc.contributor.departmentMorningside Graduate School of Biomedical Sciences
dc.description.thesisprogramClinical and Population Health Research


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