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The Gerontologist 40:587-595 (2000)
© 2000 The Gerontological Society of America

Therapy Use and Discharge Outcomes for Elderly Nursing Home Residents

Greg Arling, PhDa, Arthur R. Williams, PhDa and Donna Kopp, PTa,b

a Cookingham Institute, Bloch School of Business and Public Administration, University of Missouri at Kansas City, MO
b Currently at Medicalodges, Inc., Kansas City, KS

Correspondence: Greg Arling, PhD, Room 308, Bloch School of Business and Public Administration, University of Missouri at Kansas City, 5100 Rockhill Road, Kansas City, MO 64100. E-mail: arlingg{at}umkc.edu.

May 12, 1999 Accepted March 6, 2000 Decision Editor: Vernon L. Greene, PhD

This study examines therapy use and discharge outcomes (community discharge, mortality, or remaining in the facility) over a 90-day period for 1,419 elderly, post-acute care nursing home admissions in South Dakota. Subjects met criteria as rehabilitation candidates (i.e., absence of serious behavioral or medical conditions that would limit rehabilitation potential). Receipt of therapies was related significantly to age (younger), Medicare coverage, hip fracture or stroke diagnosis, absence of cancer diagnosis, and resident or staff expectations for functional improvement. Therapy use was related positively to community discharge and negatively to mortality when controlling for covariates such as age, marital status, payment source, functional status, cognitive status, and major diagnoses. Also, community discharge was related positively to the facility's volume of therapy provision and percentage of Medicare-covered stays.

Key Words: Rehabilitation • Medicare • Mortality • Community discharge • Polytomous regression




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