Caution: Nursing homes may be hazardous to your health

Data on the patient population in Utah nursing homes and on the extent of physician attendance on nursing home patients are presented and analyzed. Data gathered by the utilization review program of the Utah State Division of Health provides both a cross-sectional description of the population housed in nursing homes and longitudinal perspective on changes in these patients from 1971 through 1973. The condition of 75% of the patients in comprehensive care homes, i.e., those supervised by registered nurses, was found to be deteriorating or fluctuating. In intermediate and personal care institutions, 48% and 70% of the patients, respectively, were maintaining their status quo. Less than 9% of patients in any class of care were improving. A significant decrease was found in the independent activities of most patient groups over the years considered. All patient groups except the mentally retarded patients in comprehensive care homes showed a significant increase in disruptive behavioral characteristics. Non-psychiatric patients were found to receive more psychoactive drugs (e.g., tranquilizers, antidepressants) than did psychiatric patients in most homes. Patients in comprehensive care homes received frequent attention from their private physicians in the form of notes and prescription changes, but many waited months between actual examinations. The implications of the findings are discussed. Supporting data are provided.