Key result
Advance care planning documentation was initially associated with fewer hospitalizations (P=0.001), but this difference became statistically nonsignificant after adjusting for resident characteristics.
Why the study?
Research suggests advance care planning decreases nursing facility hospitalizations, but the specific associations between advance care planning documentation and hospitalizations within the OPTIMISTIC project needed to be described.
Does systematic advance care planning reduce potentially avoidable hospitalizations in long-stay nursing facility residents?
Population
1482 nursing facility residents enrolled in a demonstration project for at least 30 days
Comparison
POST comfort measures/DNH orders vs ACP orders with no hospitalization limit vs no ACP
Design
Multicenter observational demonstration project analysis across 19 nursing facilities
Authors
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May support systematic ACP in nursing facilities to reduce hospitalizations; leaves open its isolated contribution within multicomponent interventions.
Observational (n=1,482)
Yes
Does systematic advance care planning reduce potentially avoidable hospitalizations in long-stay nursing facility residents?
p-value: p=nonsignificant
Systematic advance care planning alone was not independently associated with reduced hospitalization rates in nursing facility residents after adjusting for baseline characteristics.
Hickman et al. (2019) conducted an observational in Long-stay nursing facility residents (n=1,482). Advance care planning (ACP) documentation vs. No ACP was evaluated on Potentially avoidable and all-cause hospitalizations per 1000 resident days (p=nonsignificant). Advance care planning documentation was initially associated with fewer hospitalizations (P=0.001), but this difference became statistically nonsignificant after adjusting for resident characteristics.
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