Length of stay in residential aged care: Patterns and determinants from a population-based cohort study

Abstract

The length of stay in permanent residential care is a crucial metric for evaluating the utilization of institutional care and informing sustainable aged care policies. Understanding this metric is especially relevant in Australia, where the decision on how to pay the substantial nursing home accommodation costs must be made shortly after admission and is heavily influenced by the expected duration of stay. We investigate the length of stay in long-term institutional care by analyzing a cohort of older Australians first admitted to permanent residential care in 2008. By employing survival analysis that captures time-varying covariates, we find that, in addition to demographic factors like age and gender, the organization type of nursing homes and their service size significantly influence the length of stay. Failing to account for potential changes due to transfers between nursing homes can lead to a significant underestimation of the impact of organization type and service size.