Morbidly Obese Older Adults More Often Admitted to NHs of Poorer Quality

In an article published online ahead of print in the Journal of the American Geriatrics Society, researchers found that nursing homes (NHs) that admitted more morbidly obese residents were also more likely to have more severe deficiencies in care (doi: 10.1111/jgs.14105). 

For this retrospective study, researchers examined 164,256 records of individuals aged 65 years and older newly admitted to a NH in the New York state from 2006-2007. They also examined the nursing homes’ total number of deficiency citations and quality-of-care deficiencies to determine the quality of care that the homes provided. 

Total 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] 30.0–39.9 kg/m2) and morbid obesity (BMI ≥ 40.0 kg/m2) separately and admission to facilities with more deficiencies. About 22% of older adults admitted to NHs were obese, and nearly 4% were considered morbidly obese.

They reported that NHs that admitted a higher proportion of morbidly obese residents were more likely to have more deficiencies, whether total or health care 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.

They ultimately concluded that morbidly obese residents were more likely to be admitted to NHs of poorer quality based on deficiency citations. The researchers said that their study raises concern about creating equal opportunities for obese elders to gain access to NHs that provide the highest quality of care, and that the factors driving these disparities require further elucidation. —Amanda Del Signore