Transfers from long term care to acute care hospital

Transfers from long term care to acute care hospital: Measuring harms and benefits, generating evidence to support resident centered decision making
Dr. Kobewka’s lab is studying health outcomes and health care utilization for long-term care residents who become ill and are transferred to hospital. For some residents, transfer to acute care prolongs life and improves function, for others it has no benefit or causes harm by prolonging life in states of disability or suffering that are unacceptable to the resident. His team is engaged in a 4 year mixed methods study with a goal to ensure that transfers to hospital are guided by resident’s goals and wishes. The team is using semi-structured interviews, large data base analysis, and co-design workshops to support decisions about transfer. Their quantitative analyses include marginal structural models and instrumental variable analyses to adjust for unmeasured confounding to understand potentially causal relationships.