Are Obese Residents More Likely to Be Admitted to Nursing Homes That Have More Deficiencies in Care?

作者：Zhang Ning^*; Li Yue; Rodriguez Monguio Rosa; Barenberg Andrew; Temkin Greener Helena; Gurwitz Jerry

来源：Journal of the American Geriatrics Society, 2016, 64(5): 1085-1090.

DOI：10.1111/jgs.14105

• obesity
• morbidly obese
• nursing home
• deficiency in care

ObjectivesTo determine whether obese older adults who qualify for nursing home (NH) placement are as likely as nonobese adults to be admitted to NHs that provide adequate quality of care.
DesignRetrospective study.
SettingNHs in New York State.
ParticipantsIndividuals aged 65 and older newly admitted to a NH in New York State in 2006-07.
MeasurementsTotal and healthcare-related deficiency citations for each facility were obtained from the Online Survey, Certification, and Reporting file. Bivariate and multivariate regression analyses were used to assess the association between obesity (body mass index (BMI) 30.0-39.9kg/m(2)) and morbid obesity (BMI40.0kg/m(2)) separately and admission to facilities with more deficiencies.
ResultsNHs that admitted a higher proportion of morbidly obese residents were more likely to have more deficiencies, whether total or healthcare related. These NHs also had greater odds of having severe deficiencies, or falling in the top quartile ranking of total deficiencies. After sequentially controlling for the choice of facilities within the inspection region, resident characteristics, and facility covariates, the association between morbid obesity and admission to higher-deficiency NHs persisted.
ConclusionResidents with morbid obesity were more likely to be admitted to NHs of poorer quality based on deficiency citations. The factors driving these disparities and their impact on the care of obese NH residents require further elucidation.

• 出版日期2016-5