Change over time in characteristics and survival of residents newly admitted to nursing homes: an analysis of health insurance claims data from 2011 to 2020 in Germany

Background Studies on changes in characteristics and survival of nursing home residents (NHRs) are rare. Therefore, this study aims to analyze ten-year trends in newly admitted German NHRs. Methods For this retrospective cohort study, claims data of a regional German health insurance fund was used to identify all residents aged 65 years and older newly admitted to a nursing home between 2011 and 2020 (with a follow-up period ending on December 31, 2021). Characteristics of NHRs were analysed descriptively and stratified by 5 two-year cohorts. Survival times and mortality were assessed by applying the Kaplan–Meier-method and a cox regression was used. Results A total of 113,929 residents were newly admitted between 2011 and 2020 (69% female; mean age 83.8 years). Over the years, the proportion of men and the mean age slightly increased. Prevalence of dementia remained nearly stable (45–48%) while cancer prevalence raised from 30 to 37%. Overall, median survival time decreased from 745 days in 2011/2012 to 615 days in 2019/2020. Survival times in residents with dementia decreased significantly (median survival from 790 to 651 days) while it remained nearly unchanged in cancer patients (from 444 to 410 days). Conclusions We found that survival after nursing home admission decreased in Germany from 2011 to 2020, which was accompanied by shorter survival in residents with dementia and by an increasing proportion of those with cancer, who already experience higher mortality. There is a growing need to integrate palliative care in nursing homes and to also provide appropriate care for older patients with cancer outside nursing homes.