Identifying and characterizing subgroups of medically complex older patients in community-based intermediate care: a latent class analysis of Danish municipal temporary stay patients

BACKGROUND: In Denmark, municipal temporary stays (TS) have been established in all municipalities as intermediate care structures to receive mostly older patients who require short-term care that cannot be provided at their own residence. These patients are admitted to TS facilities, usually but not necessarily after hospitalization. This study aims to identify subgroups of medically complex TS patients by analyzing demographic and clinical variables. METHODS: We identified a cohort of 11,284 patients with at least one temporary stay across 14 Danish municipalities during 2016–2023. Demographic and clinical information were obtained from Danish administrative and health registries. We employed latent class analysis to identify subgroups of patients. We characterized the subgroups by statistical analysis of patient characteristics and outcomes across subgroups and established patient profiles. RESULTS: We uncovered five patient subgroups: SG1: middle-old multimorbid patients (38%), SG2: oldest-old women with low multimorbidity (18%), SG3: younger-old men with low polypharmacy (18%), SG4: middle-old patients with low hospitalization burden (11%), SG5: younger-old men with extreme chronic conditions (15%). Two subgroups, SG1 and SG5, demonstrated higher 30-day mortality, with the latter having the highest 30-day hospital admission rates. Two other subgroups, SG2 and SG3, had longer temporary stays and longer survival times. SG4 patients had the shortest temporary stays, low 30-day mortality, and the lowest 30-day hospital admissions. The distribution of morbidities and prescribed drugs across subgroups showed distinct patterns that underscored the different care needs. CONCLUSION: TS patients are heterogeneous and have complex care needs. We identified five patient subgroups with distinct patterns in demographics, morbidities, prescribed medication, health care use, and outcomes. These findings support stratified care planning in TS and suggest that comprehensive geriatric assessment may be particularly relevant for the predominantly older TS population, while individualized multidisciplinary assessment remains important across patient groups.