Characteristics of Residents With Do-Not-Resuscitate Orders in Nursing Homes
David H. Mark, MD, MPH;
John Bahr, PhD;
Edmund H. Duthie, MD;
Donald D. Tresch, MD
Arch Fam Med. 1995;4(5):463-467.
We determined patient characteristics associated with do-not-resuscitate (DNR) status in nursing homes using cross-sectional analysis of secondary data derived from Minimum Data Set documents in 14 nursing homes from one state in the upper Midwest. The primary outcome variable was DNR status. Bivariate analysis was first carried out on all variables. Variables associated with DNR status at this stage were then included in a stepwise logistic regression to determine variables independently associated with DNR status. Overall, 71% of patients had DNR orders. Variables found to be independently associated with a higher probability of DNR status were increasing age, female gender, worse cognitive function, durable power of attorney, being self-paying, or having commercial insurance. Lack of daily contact with relatives and friends and lack of involvement with others were associated with lower probability of DNR status. A higher prevalence of DNR status in nursing homes was seen than in prior literature. The patient characteristics shown to be associated with DNR status may give important insight into the reasons that such decisions are made.
From the Departments of Family and Community Medicine (Dr Mark) and Medicine (Drs Duthie and Tresch), Medical College of Wisconsin, and Healthcare Assurance Systems, Inc (Dr Bahr), Milwaukee, Wis.
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