{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T22:24:36Z","timestamp":1781130276020,"version":"3.54.1"},"reference-count":48,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,8,9]],"date-time":"2018-08-09T00:00:00Z","timestamp":1533772800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["U01AG032947"],"award-info":[{"award-number":["U01AG032947"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG047859"],"award-info":[{"award-number":["R01AG047859"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To comprehensively examine factors associated with long\u2010term nursing home (NH) entry from 6 domains of older adult and family caregiver risk from nationally representative surveys and develop a prognostic model and a simple scoring system for use in risk stratification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>National Long\u2010Term Care Surveys 1999 and 2004 and National Health and Aging Trends Study 2011 and linked caregiver surveys.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Community\u2010living older adults receiving help with self\u2010care disability and their primary family or unpaid caregiver (N=2,676).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Prediction of long\u2010term NH entry (&gt;100 days or ending in death) by 24 months follow up, ascertained from Minimum Data Set assessments and dates of death from Medicare enrollment files. Risk factors were measured from survey responses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 16.1% of older adults entered a NH. Our final model and risk scoring system includes 7 independent risk factors: older adult age (1 point\/5 years), living alone (5 points), dementia (3 points), 3 or more of 6 self\u2010care activities (2 points), caregiver age (45\u201364: 1 point, 65\u201374: 2 points, \u226575: 4 points), caregiver help with money management (2 points), and caregiver report of moderate (2 points) or high (4 points) strain. Using this model, participants were assigned to risk quintiles. Long\u2010term NH entry was 7.0% in the lowest quintile (0\u20136 points), 20.4% in the middle 3 quintiles (7\u201314 points), and 30.9% in the highest quintile (15\u201322 points). The model was well calibrated and demonstrated moderate discrimination (c\u2010statistic=0.670 in the original data, c\u2010statistic=0.647 in bootstrapped samples, c\u2010statistic=0.652 using the point\u2010scoring system).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We developed a prognostic model and simple scoring system that may be used to stratify risk of long\u2010term NH entry of community\u2010living older adults. Our model may be useful for population health and policy applications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.15447","type":"journal-article","created":{"date-parts":[[2018,8,10]],"date-time":"2018-08-10T02:28:31Z","timestamp":1533868111000},"page":"1887-1894","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Long\u2010Term Nursing Home Entry: A Prognostic Model for Older Adults with a Family or Unpaid Caregiver"],"prefix":"10.1111","volume":"66","author":[{"given":"Jennifer L.","family":"Wolff","sequence":"first","affiliation":[{"name":"Department of Health Policy and Management Bloomberg School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Mulcahy","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Bloomberg School of Public 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