Abstract:

Objective To prepare and assess the authenticity and feasibility of Admission and Discharge Criteria for Geriatric Nursing Homes in Shanghai according to experiences both at home and abroad and domestic status. Methods Admission and Discharge Criteria for Geriatric Nursing Homes in Shanghai was prepared via literature review, questionnaire survey, and expert interview and converted to a system software. Inpatients in 26 geriatric nursing homes in Shanghai were assessed by physicians and the software system. The consistency between criteria assessment and physician assessment was analyzed and the sensitivity and specificity of criteria assessment were calculated. Characteristics of inpatient population distribution in geriatric nursing homes in Shanghai were analyzed. Results Kappa consistency test showed that the Kappa value of criteria assessment and physician assessment results was 0.931 (P=0.006). The sensitivity and specificity of the criteria assessment were 98.40% (95%CI98.03%-98.76%) and 96.20% (95%CI95.15%-97.26%) taking the physician assessment as a gold standard. Analysis of the characteristics of inpatient population distribution in geriatric nursing homes in Shanghai showed that more elderly patients in suburb areas should be discharged or transferred but still remained hospitalized as compared with those in urban areas (P=0.000). The proportion of patients using social insurance was higher than those using other payment methods (P=0.016). The proportion of cadre population was significantly higher than other populations (P=0.004). The proportion of eligible patients admitted by independent community health centers was the highest (84.1%). The proportion of ineligible patients with diabetes was the highest (32.4%). Conclusion Admission and Discharge Criteria for Geriatric Nursing Homes in Shanghai can truly, objectively, and effectively assess whether elderly patients in Shanghai are eligible for the admission and discharge criteria for geriatric nursing homes.

Key words: nursing homes, admission and discharge, standard