Determinants of survival in continuing care settings.

Objective: To assess the relationship between the Barthel Index, a widely used assessment measure of physical dependency, and long-term survival in continuing care settings.

Design And Subjects: One hundred and eighty five older people moving into continuing care (hospital or nursing home) were prospectively assessed with regard to physical and mental impairment in 1991/2 and this population was followed up in 1996.

Results: In addition to the 185 patients who were assessed, there were 41 patients who died before they could be seen. Out of the total of 226 patients, 177 had died by the time of the census point in 1996. Multivariate (Cox regression) analysis of survival in the 185 patients indicated that only the Barthel Index (BI) and female sex were statistically significantly related to survival rates. Those with a BI of 12-20 had better survival than those with a BI of 7-11 (P = 0.015) or a BI of 0-6 (P = 0.007).

Conclusions: The importance of careful assessment of those moving into continuing care settings is emphasised. Those patients who are physically less dependent are likely to have significantly longer survival periods and related use of continuing care resources.