Derek R Manis, David Kirkwood, Stacey Fisher, Wenshan Li, Colleen Webber, Peter Tanuseputro, Nathan M Stall, Jennifer A Watt, Amy T Hsu, Rachel D Savage, Susan E Bronskill, Andrew P Costa
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引用次数: 0
Abstract
Objectives: To examine transitions to a nursing home among residents of assisted living relative to community-dwelling home care recipients.
Design: Population-based retrospective cohort study emulating a target trial.
Setting and participants: Linked, individual-level health system data were obtained from older adults (≥65 years of age) who made an incident application for a bed in a nursing home in Ontario, Canada, between April 1, 2014, and March 31, 2019, and were followed until December 31, 2019.
Methods: Residency in assisted living was compared with only community-dwelling home care. Any long-stay (≥90 days) and short-stay (<90 days) transitions to a nursing home were examined. Inverse probability weighted pooled logistic regression models were used to generate marginal cumulative incidence curves under each exposure status that were standardized by the covariates.
Results: This study included 10,012 residents of assisted living (mean [SD] age 88.7 [6.26] years, 75% female) and 131,679 home care recipients (mean [SD] age 84.8 [7.43] years, 63% female) who applied for a bed in a nursing home (N = 141,691; 95,744.6 person-years). There were 6049 transitions among applicants from assisted living and 85,190 transitions among applicants who were home care recipients to a nursing home. The 5-year absolute risk reduction was 110 transitions to a nursing home per 1000 older adult applicants if all applicants resided in assisted living (95% CI, 71-148). Residency in assisted living resulted in a 12.7% relative decrease in the 5-year risk of any transition to a nursing home had all applicants resided in assisted living (95% CI, 8.3%-17.1%).
Conclusions and implications: Residents of assisted living were less likely to transition to a nursing home, despite equivalent clinical complexity and health care needs. The integration of assisted living into the continuum of care from the community to institutionalized nursing homes would better inform health system capacity and planning.
期刊介绍：
JAMDA, the official journal of AMDA - The Society for Post-Acute and Long-Term Care Medicine, is a leading peer-reviewed publication that offers practical information and research geared towards healthcare professionals in the post-acute and long-term care fields. It is also a valuable resource for policy-makers, organizational leaders, educators, and advocates.
The journal provides essential information for various healthcare professionals such as medical directors, attending physicians, nurses, consultant pharmacists, geriatric psychiatrists, nurse practitioners, physician assistants, physical and occupational therapists, social workers, and others involved in providing, overseeing, and promoting quality
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