TOPLINE:

Older adults spent markedly less time at home after being discharged from the hospital for serious health events — especially after critical illness and nonelective surgery.

METHODOLOGY:

• Researchers analyzed data from a prospective cohort to assess how many days older, community‑living adults spent at home in the 180 days after discharge from the hospital for serious health events.
• They included 754 adults aged 70 years or older (mean age, 78.4 years; 64.6% women) enrolled in a South Central Connecticut health plan between March 1998 and October 1999.
• Serious health events comprised critical illness requiring care in the ICU, nonelective major surgery, elective major surgery, and other hospital admissions, primarily ascertained through Medicare data.
• Days at home were calculated as the 180 days after discharge minus overnight stays in healthcare facilities and days not alive, with assessments performed every 18 months and monthly interviews conducted through 2024.
• Researchers selected a random sample of 500 observations from 18-month intervals during which participants were not hospitalized to serve as the nonevent reference group.

TAKEAWAY:

• Time spent at home was 48.6 days shorter after critical illness, 50.1 days shorter after nonelective major surgery, 20.7 days shorter after elective major surgery, and 22.9 days shorter after other hospitalizations than in the nonevent reference group.
• Adjusted analyses showed that mean days at home were 30% fewer after critical illness and nonelective major surgery, 13% fewer after elective major surgery, and 14% fewer after other hospitalizations than in the nonevent reference group.
• Mortality rates over 180 days were highest for critical illness (30.4%), followed by nonelective surgery (17.8%), other hospitalizations (14.7%), elective surgery (5.8%), and in the nonevent reference group (2.4%).
• Most time spent away from home was in nursing facilities, except after critical illness, when a larger proportion of time away was attributable to death.

IN PRACTICE:

“These findings provide strong evidence that days spent at home are considerably diminished after serious health events, with critical illness and nonelective major surgery being the most deleterious,” the researchers of the study wrote.

SOURCE:

The study was led by Thomas M. Gill, MD, of Yale School of Medicine in New Haven, Connecticut. It was published online on March 10 in Journal of the American Geriatrics Society.

LIMITATIONS:

Researchers analyzed only the first serious event per 18‑month interval. Participants came from a single health plan in South Central Connecticut.

DISCLOSURES:

The study received funding from the National Institute on Aging and was conducted at the Yale Claude D. Pepper Older Americans Independence Center. The authors declared having no conflicts of interest. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.