Factors Related to Institutionalization in Elderly With Dementia: Analysis of Nationwide Population-Based Data

Abstract

Objective: Patients with dementia often require institutionalization as their disease progresses, but institutionalization may be associated with several negative outcomes including increased mortality. This study aimed to investigate factors related to institutionalization in patients with dementia in South Korea using nationwide population-based data. Methods: National Health Insurance Service and Long-Term Care Insurance (LTCI) database were used for analysis. The study population consisted of patients with dementia aged 65 years or older who qualified for LTCI institutional care benefits from 2008 to 2017. Multiple logistic regression was used to analyze factors related to institutionalization in patients with dementia. Results: We identified 141,552 patients, of which 90,110 were institutionalized and 51,442 were not. Older age, female sex, low income, non-family caregiver, less comorbidities, no disability and diagnosis of Alzheimer’s disease (AD) were related to institutionalization. Conclusion: Consistent with previous studies, older age and diagnosis of AD were related to institutionalization. In addition, low income and non-family caregiver were associated with institutionalization, which may be due to insufficient home care service in South Korea.