Association Between Dementia Care Programs in Assisted Living Facilities and Transitions to Nursing Homes in Ontario, Canada: A Population-Based Cohort Study.

Aged Assisted Living Facilities Cohort Studies Dementia / therapy Humans Nursing Homes Ontario Retrospective Studies
Dementia care assisted living facilities long-term care nursing homes retirement homes

Journal

Journal of the American Medical Directors Association
ISSN: 1538-9375
Titre abrégé: J Am Med Dir Assoc
Pays: United States
ID NLM: 100893243

Informations de publication

Date de publication:
10 2021
Historique:
received: 25 03 2021
revised: 25 06 2021
accepted: 08 07 2021
pubmed: 6 8 2021
medline: 21 10 2021
entrez: 5 8 2021
Statut: ppublish

Résumé

We investigate whether older adults who were newly diagnosed with dementia (severity unspecified) and resided in an assisted living facility that offered a dementia care program had a lower rate of transition to a nursing home, compared to those who resided in an assisted living facility without such a program. Population-based retrospective cohort study. Linked, person-level health system administrative data on older adults who were newly diagnosed with dementia and resided in an assisted living facility in Ontario, Canada, from 2014 to 2019 (n = 977). Access to a dementia care program in an assisted living facility (n = 57) was examined. Multivariable Cox proportional hazards regression with robust standard errors clustered on the assisted living facility was used to model the time to transition to a nursing home from the new dementia diagnosis. There were 11.8 transitions to a nursing home per 100 person-years among older adults who resided in an assisted living facility with a dementia care program, compared with 20.5 transitions to a nursing home per 100 person-years among older adults who resided in an assisted living facility without a dementia care program. After adjustment for relevant characteristics at baseline, older adults who resided in an assisted living facility with a dementia care program had a 40% lower rate of transition to a nursing home (hazard ratio 0.60, 95% confidence interval 0.44, 0.81), compared with those in an assisted living facility without such a program at any point during the follow-up period. The rate of transition to a nursing home was significantly lower among older adults who resided in an assisted living facility that offered a dementia care program. These findings support the expansion of dementia care programs in assisted living facilities.

Identifiants

DOI: 10.1016/j.jamda.2021.07.002 PMID: 34352202
pubmed: 34352202
pii: S1525-8610(21)00640-X
doi: 10.1016/j.jamda.2021.07.002
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2115-2120.e6

Informations de copyright

Copyright © 2021 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Auteurs

Derek R Manis (DR)

Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; ICES, Toronto, ON, Canada. Electronic address: manisd@mcmaster.ca.

Ahmad Rahim (A)

ICES, Toronto, ON, Canada.

Jeffrey W Poss (JW)

School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.

Iwona A Bielska (IA)

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.

Susan E Bronskill (SE)

ICES, Toronto, ON, Canada; Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada; Women's College Research Institute, Toronto, ON, Canada; Sunnybrook Research Institute, Toronto, ON, Canada.

Jean-Éric Tarride (JÉ)

Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.

Julia Abelson (J)

Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.

Andrew P Costa (AP)

Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; ICES, Toronto, ON, Canada; Centre for Integrated Care, St. Joseph's Health System, Hamilton, ON, Canada; Schlegel Research Institute for Aging, Waterloo, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Association Between Dementia Care Programs in...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Établissements de santé › Établissements de soins de long séjour › Établissements d'aide à la vie autonome › Association Between Dementia Care Programs in...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Association Between Dementia Care Programs in...
questionsmedicales.fr › Troubles mentaux › Troubles neurocognitifs › Démence › Association Between Dementia Care Programs in...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Association Between Dementia Care Programs in...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Établissements de santé › Établissements de soins de long séjour › Maisons de repos › Association Between Dementia Care Programs in...
questionsmedicales.fr › Régions géographiques › Amériques › Amérique du Nord › Canada › Ontario › Association Between Dementia Care Programs in...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Association Between Dementia Care Programs in...