TY - JOUR
T1 - Urban/Rural in Decision Making and the Use of Advance Directives among Nursing Home Residents at Admission
AU - Buchanan, Robert J.
AU - Bolin, Jane
AU - Wang, Suojin
AU - Zhu, Li
AU - Kim, Myung Suk
PY - 2004/3
Y1 - 2004/3
N2 - Context: Advance directives promote patient autonomy and encourage greater awareness of final care options while reducing physician and family uncertainty regarding patient preferences. Purpose: To investigate differences in decision making authority and the use of advance directives among nursing home residents admitted from urban and rural areas. Methods: A total of 551,208 admission assessments in the Minimum Data Set were analyzed for all residents admitted to a nursing facility in 2001. Using the Rural Urban Commuting Areas (RUCA) methodology and ZIP code of primary residence before admission, these residents were classified into 4 urban/rural areas. Findings: Residents from rural areas were significantly more likely to have executed a durable power of attorney for health care or for financial decisions than residents admitted from the other areas, with the largest differences observed between residents admitted from urban and rural areas. Almost 6 residents in 10 from urban areas had no advance directives in place at admission compared with only 4 residents in 10 admitted from rural areas. Conclusions: Health providers and social workers in both rural and urban areas should advise patients about the value of advance directives.
AB - Context: Advance directives promote patient autonomy and encourage greater awareness of final care options while reducing physician and family uncertainty regarding patient preferences. Purpose: To investigate differences in decision making authority and the use of advance directives among nursing home residents admitted from urban and rural areas. Methods: A total of 551,208 admission assessments in the Minimum Data Set were analyzed for all residents admitted to a nursing facility in 2001. Using the Rural Urban Commuting Areas (RUCA) methodology and ZIP code of primary residence before admission, these residents were classified into 4 urban/rural areas. Findings: Residents from rural areas were significantly more likely to have executed a durable power of attorney for health care or for financial decisions than residents admitted from the other areas, with the largest differences observed between residents admitted from urban and rural areas. Almost 6 residents in 10 from urban areas had no advance directives in place at admission compared with only 4 residents in 10 admitted from rural areas. Conclusions: Health providers and social workers in both rural and urban areas should advise patients about the value of advance directives.
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U2 - 10.1111/j.1748-0361.2004.tb00019.x
DO - 10.1111/j.1748-0361.2004.tb00019.x
M3 - Article
C2 - 15085626
AN - SCOPUS:3042821170
VL - 20
SP - 131
EP - 135
JO - Journal of Rural Health
JF - Journal of Rural Health
SN - 0890-765X
IS - 2
ER -