Increased Risk of Hospitalization in Older LTSS Recipients With Heart/Lung Conditions

Older adults receiving long-term services and supports (LTSS), and who have both heart and lung conditions, have an elevated risk of hospitalization, according to a study published in Nursing Research (2016;65[6]:425-434).

Multiple chronic conditions (MCCs) are prevalent in LTSS recipients. However, the relationship of MCCs and diseases associated with hospitalizations of LTSS recipients is unclear. Janet H Van Cleave, PhD, RN, New York University Rory Meyers College of Nursing (New York, NY), and colleagues set out to determine the association between classes of MCCs in newly enrolled LTSS recipients and the number of hospitalizations over a 1-year period following enrollment.

Dr Van Cleave and her team analyzed extant data from a longitudinal cohort study of 470 new recipients of LTSS, aged 60 and older, receiving services in assisted-living facilities, nursing homes, or through home- and community-based services.

Three latent MCC-based classes named Cardiopulmonary, Cerebrovascular/Paralysis, and All Other Conditions were identified. The Cardiopulmonary class was associated with elevated numbers of hospitalizations compared with the All Other Conditions class. 

“Ultimately, new care management strategies are needed to meet the desires and needs of persons living with multiple chronic conditions that limit their capacity for self-care,” said Dr Van Cleave. Such strategies, the researchers said, include the use of sophisticated analyses, such as latent class analysis, to help identify and intervene early in populations at risk for hospitalization. 

Additional interventions, such as the prevention or management of polypharmacy as well as transitional care from hospital to residence within services provided by medical homes, need more study, they said.—Amanda Del Signore