Abstract
Objective
To examine home care service-related and person-based factors associated with time
to entry into permanent residential aged care.
Design
Longitudinal cohort study using routinely collected client management data.
Setting
A large aged care service provider in New South Wales and the Australian Capital Territory,
Australia.
Participants
A total of 1116 people aged 60 years and older who commenced home care services for
higher-level needs between July 1, 2015 and June 30, 2016.
Methods
Survival analysis methods were used to examine service-related and person-based factors
that were associated with time between first home care service and entry into permanent
residential aged care. Predictors included service hours per week, combination of
service types, demographics, needs, hospital leave, and change in care level. Cluster
analysis was used to determine patterns of types of services used.
Results
By December 31, 2016, 21.1% of people using home care services had entered into permanent
residential care (n = 235). After adjusting for significant factors such as age and
care needs, each hour of service received per week was associated with a 6% lower
risk of entry into residential care (hazard ratio = 0.94, 95% confidence interval
0.90-0.98). People who were predominant users of social support services, those with
an identified carer, and those born in a non-main English-speaking country also remained
in their own homes for longer.
Conclusions
Greater volume of home care services was associated with significantly delayed entry
into permanent residential care. This study provides much-needed evidence about service
outcomes that could be used to inform older adults’ care choices.
Keywords
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Article info
Publication history
Published online: September 23, 2017
Footnotes
This work was supported by an Australian Research Council Linkage Grant (LP120200814) undertaken in partnership with Uniting. The study was approved by the Macquarie University Human Research Ethics committee (Reference No: 5201401031) who waivered participant written consent.
Identification
Copyright
Crown Copyright © 2017 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
