Factors Affecting Discharge to Home of Geriatric Intermediate Care Facility Residents in Japan

Objectives To investigate factors associated with lower likelihood of discharge to home from geriatric intermediate care facilities in Japan. Design Retrospective cohort study. Setting We used data from the nationwide long-term care (LTC) insurance claims database (April 2012-March 2014). Participants Study participants were 342,758 individuals newly admitted to 3,459 geriatric intermediate care facilities during the study period. Measurements The primary outcome was discharge to home. We performed a multivariable competing-risk Cox regression with adjustment for resident-, facility-, and region-level characteristics. Resident level of care needs and several medical conditions were included as time-varying covariates. Death, admission to a hospital, and admission to another LTC facility were treated as competing risks. Results During the 2-year follow-up period, 19% of participants were discharged to home. In the multivariable competing-risk Cox regression, the following factors were significantly associated with lower likelihood of discharge to home: older age, higher level of care need, having several medical conditions, private ownership of the facility, more beds in the facility, and more LTC facility beds per 1,000 adults aged 65 and older in the region. Conclusion Only 19% of residents were discharged to home. Our results are useful for policy-makers to promote discharge to home of older adults in geriatric intermediate care facilities.