• Mark McCann, Dermot O'Reilly, and Chris Cardwell.
• Queen's University Belfast, Centre for Public Health, Mulhouse, Royal Hospitals Site, Grosvenor Road, Belfast, BT12 6BJ, UK. mmccann13@qub.ac.uk
• Age Ageing. 2009 Nov 1; 38 (6): 711-7.

Backgrounddespite the intensive services provided to residents of care homes, information on death rates is not routinely available for this population in the UK.Objectiveto quantify mortality rates across the care home population of Northern Ireland, and assess variation by type of care home and resident characteristics.Designa prospective, Census-based cohort study, with 5-year follow-up.Participantsall 9,072 residents of care homes for people aged 65 and over at the time of the 2001 census with a special emphasis on the 2,112 residents admitted during the year preceding census day.Measurementsage, sex, self-reported health, marital status, residence (not in care home, residential home, dual registered home, nursing home), elderly mentally infirm care provision.Resultsthe median survival among nursing home residents was 2.33 years (95% CI 2.25-2.59), for dual registered homes 2.75 (95% CI 2.42-3.17) and for residential homes 4.51 (95% CI 3.92-4.92) years. Age, sex and self-reported health showed weaker associations in the sicker populations in nursing homes compared to those in residential care or among the non-institutionalised.Conclusionsthe high mortality in care homes indicates that places in care homes are reserved for the most severely ill and dependent. Death rates may not be an appropriate care quality measure for this population, but may serve as a useful adjunct for clinical staff and the planning of care home provision.

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