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Research article
Peter Tanuseputro
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4409-0795
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Background: Hospitalizations carry considerable risks for frail, elderly patients; this is especially true for patients with dementia, who are more likely to experience delirium, falls, functional decline, iatrogenic complications, and infections when compared to their peers without dementia. Since up to two thirds of patients in long-term care (LTC) facilities have dementia, there is interest in identifying factors associated with transitions from LTC facilities to hospitals. The purpose of this study was to investigate the association between dementia status and incidence of hospitalization among residents in LTC facilities in Ontario, Canada, and to determine whether this association is modified by linguistic factors.
Methods: We used linked administrative databases to establish a prevalent cohort of 81,188 residents in 628 LTC facilities from April 1st 2014 to March 31, 2017. Diagnoses of dementia were identified with a previously validated algorithm; all other patient characteristics were obtained from in-person assessments. Residents’ primary language was coded as English or French; facility language (English or French) was determined using language designation status according to the French Language Services Act. We identified all hospitalizations within 3 months of the first assessment performed after April 1st 2014. We performed multivariate logistic regression analyses to determine the impact of dementia and resident language on the incidence of hospitalization; we also considered interactions between dementia and both resident language and resident-facility language discordance.
Results: The odds of hospitalization were 39% lower for residents with dementia compared to residents without dementia (OR 0.61, 95% CI 0.57–0.65). Francophones had lower odds of hospitalization than Anglophones, but this difference was not statistically significant (OR 0.91, 95% CI 0.81 – 1.03). However, Francophones without dementia were significantly less likely to be hospitalized compared to Anglophones without dementia (OR 0.71, 95% CI 0.53 – 0.94). Resident-facility language discordance did not significantly affect hospitalizations.
Conclusions: Residents in LTC facilities were generally less likely to be hospitalized if they had dementia, or if their primary language was French and they did not have dementia. These findings could be explained by differences in end-of-life care goals; however, they could also be the result of poor patient-provider communication.
Keywords
Dementia, Language, Long-term care, Hospitalizations, Nursing homes
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CURRENT STATUS: Published
View the published article at BMC Geriatrics.
No community comments so far
Submission checks complete
On 30 Sep, 2020
Editorial decision: Accept
On 30 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 14 Sep, 2020
Editor assigned
On 07 Sep, 2020
Submission checks complete
On 06 Sep, 2020
Editor invited
On 06 Sep, 2020
Version 1
Posted 19 Jun, 2020
No comments provided
Review #1 received
Received 06 Aug, 2020
Editorial decision: Major revision
On 06 Aug, 2020
Review #2 received
Received 01 Aug, 2020
Reviewer #2 agreed
On 10 Jul, 2020
Reviewer #1 agreed
On 02 Jul, 2020
Reviewers invited
Invitations sent on 22 Jun, 2020
Editor assigned
On 17 Jun, 2020
First submitted
On 16 Jun, 2020
Submission checks complete
On 16 Jun, 2020
Editor invited
On 16 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Geriatrics & Gerontology
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A new preprint design is coming!
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See the published version of this preprint at BMC Geriatrics.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Peter Tanuseputro
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4409-0795
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Geriatrics.
No community comments so far
Submission checks complete
On 30 Sep, 2020
Editorial decision: Accept
On 30 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 14 Sep, 2020
Editor assigned
On 07 Sep, 2020
Submission checks complete
On 06 Sep, 2020
Editor invited
On 06 Sep, 2020
Version 1
Posted 19 Jun, 2020
No comments provided
Review #1 received
Received 06 Aug, 2020
Editorial decision: Major revision
On 06 Aug, 2020
Review #2 received
Received 01 Aug, 2020
Reviewer #2 agreed
On 10 Jul, 2020
Reviewer #1 agreed
On 02 Jul, 2020
Reviewers invited
Invitations sent on 22 Jun, 2020
Editor assigned
On 17 Jun, 2020
First submitted
On 16 Jun, 2020
Submission checks complete
On 16 Jun, 2020
Editor invited
On 16 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Geriatrics & Gerontology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Geriatrics.
Background: Hospitalizations carry considerable risks for frail, elderly patients; this is especially true for patients with dementia, who are more likely to experience delirium, falls, functional decline, iatrogenic complications, and infections when compared to their peers without dementia. Since up to two thirds of patients in long-term care (LTC) facilities have dementia, there is interest in identifying factors associated with transitions from LTC facilities to hospitals. The purpose of this study was to investigate the association between dementia status and incidence of hospitalization among residents in LTC facilities in Ontario, Canada, and to determine whether this association is modified by linguistic factors.
Methods: We used linked administrative databases to establish a prevalent cohort of 81,188 residents in 628 LTC facilities from April 1st 2014 to March 31, 2017. Diagnoses of dementia were identified with a previously validated algorithm; all other patient characteristics were obtained from in-person assessments. Residents’ primary language was coded as English or French; facility language (English or French) was determined using language designation status according to the French Language Services Act. We identified all hospitalizations within 3 months of the first assessment performed after April 1st 2014. We performed multivariate logistic regression analyses to determine the impact of dementia and resident language on the incidence of hospitalization; we also considered interactions between dementia and both resident language and resident-facility language discordance.
Results: The odds of hospitalization were 39% lower for residents with dementia compared to residents without dementia (OR 0.61, 95% CI 0.57–0.65). Francophones had lower odds of hospitalization than Anglophones, but this difference was not statistically significant (OR 0.91, 95% CI 0.81 – 1.03). However, Francophones without dementia were significantly less likely to be hospitalized compared to Anglophones without dementia (OR 0.71, 95% CI 0.53 – 0.94). Resident-facility language discordance did not significantly affect hospitalizations.
Conclusions: Residents in LTC facilities were generally less likely to be hospitalized if they had dementia, or if their primary language was French and they did not have dementia. These findings could be explained by differences in end-of-life care goals; however, they could also be the result of poor patient-provider communication.
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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