Predictors of nursing home admission in the older population in Belgium: a longitudinal follow-up of health interview survey participants.
Administrative data
Competing risk analysis
Institutionalization
Linkage
Nursing home admission
Older adults
Predictors
Journal
BMC geriatrics
ISSN: 1471-2318
Titre abrégé: BMC Geriatr
Pays: England
ID NLM: 100968548
Informations de publication
Date de publication:
20 10 2022
20 10 2022
Historique:
received:
14
12
2021
accepted:
27
09
2022
entrez:
21
10
2022
pubmed:
22
10
2022
medline:
25
10
2022
Statut:
epublish
Résumé
This study examines predictors of nursing home admission (NHA) in Belgium in order to contribute to a better planning of the future demand for nursing home (NH) services and health care resources. Data derived from the Belgian 2013 health interview survey were linked at individual level with health insurance data (2012 tot 2018). Only community dwelling participants, aged ≥65 years at the time of the survey were included in this study (n = 1930). Participants were followed until NHA, death or end of study period, i.e., December 31, 2018. The risk of NHA was calculated using a competing risk analysis. Over the follow-up period (median 5.29 years), 226 individuals were admitted to a NH and 268 died without admission to a NH. The overall cumulative risk of NHA was 1.4, 5.7 and 13.1% at respectively 1 year, 3 years and end of follow-up period. After multivariable adjustment, higher age, low educational attainment, living alone and use of home care services were significantly associated with a higher risk of NHA. A number of need factors (e.g., history of falls, suffering from urinary incontinence, depression or Alzheimer's disease) were also significantly associated with a higher risk of NHA. On the contrary, being female, having multimorbidity and increased contacts with health care providers were significantly associated with a decreased risk of NHA. Perceived health and limitations were both significant determinants of NHA, but perceived health was an effect modifier on limitations and vice versa. Our findings pinpoint important predictors of NHA in older adults, and offer possibilities of prevention to avoid or delay NHA for this population. Practical implications include prevention of falls, management of urinary incontinence at home and appropriate and timely management of limitations, depression and Alzheimer's disease. Focus should also be on people living alone to provide more timely contacts with health care providers. Further investigation of predictors of NHA should include contextual factors such as the availability of nursing-home beds, hospital beds, physicians and waiting lists for NHA.
Sections du résumé
BACKGROUND
This study examines predictors of nursing home admission (NHA) in Belgium in order to contribute to a better planning of the future demand for nursing home (NH) services and health care resources.
METHODS
Data derived from the Belgian 2013 health interview survey were linked at individual level with health insurance data (2012 tot 2018). Only community dwelling participants, aged ≥65 years at the time of the survey were included in this study (n = 1930). Participants were followed until NHA, death or end of study period, i.e., December 31, 2018. The risk of NHA was calculated using a competing risk analysis.
RESULTS
Over the follow-up period (median 5.29 years), 226 individuals were admitted to a NH and 268 died without admission to a NH. The overall cumulative risk of NHA was 1.4, 5.7 and 13.1% at respectively 1 year, 3 years and end of follow-up period. After multivariable adjustment, higher age, low educational attainment, living alone and use of home care services were significantly associated with a higher risk of NHA. A number of need factors (e.g., history of falls, suffering from urinary incontinence, depression or Alzheimer's disease) were also significantly associated with a higher risk of NHA. On the contrary, being female, having multimorbidity and increased contacts with health care providers were significantly associated with a decreased risk of NHA. Perceived health and limitations were both significant determinants of NHA, but perceived health was an effect modifier on limitations and vice versa.
CONCLUSIONS
Our findings pinpoint important predictors of NHA in older adults, and offer possibilities of prevention to avoid or delay NHA for this population. Practical implications include prevention of falls, management of urinary incontinence at home and appropriate and timely management of limitations, depression and Alzheimer's disease. Focus should also be on people living alone to provide more timely contacts with health care providers. Further investigation of predictors of NHA should include contextual factors such as the availability of nursing-home beds, hospital beds, physicians and waiting lists for NHA.
Identifiants
pubmed: 36266620
doi: 10.1186/s12877-022-03496-4
pii: 10.1186/s12877-022-03496-4
pmc: PMC9585772
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
807Informations de copyright
© 2022. The Author(s).
Références
J Am Geriatr Soc. 2010 Apr;58(4):783-7
pubmed: 20345862
Gerontologist. 2005 Apr;45(2):157-66
pubmed: 15799980
BMC Health Serv Res. 2010 Jun 29;10:186
pubmed: 20584341
BMC Med Inform Decis Mak. 2017 Apr 13;17(1):39
pubmed: 28407806
Age Ageing. 1997 Sep;26(5):367-74
pubmed: 9351481
JAMA. 1982 Sep 10;248(10):1194-8
pubmed: 7109138
Age Ageing. 2010 Jan;39(1):31-8
pubmed: 19934075
Comput Methods Programs Biomed. 2015 Feb;118(2):218-33
pubmed: 25572709
BMC Geriatr. 2007 Jun 19;7:13
pubmed: 17578574
J Am Geriatr Soc. 2018 Oct;66(10):1887-1894
pubmed: 30094823
Circulation. 2016 Feb 9;133(6):601-9
pubmed: 26858290
PLoS One. 2015 Dec 14;10(12):e0144203
pubmed: 26658776
J Am Geriatr Soc. 2004 May;52(5):712-8
pubmed: 15086650
BMC Geriatr. 2020 Oct 31;20(1):439
pubmed: 33129263
J Stroke Cerebrovasc Dis. 2015 Oct;24(10):2329-37
pubmed: 26169547
J Am Geriatr Soc. 2006 Apr;54(4):593-7
pubmed: 16686868
Dement Geriatr Cogn Dis Extra. 2013 Nov 01;3(1):426-45
pubmed: 24348504
CMAJ. 2020 Apr 20;192(16):E422-E430
pubmed: 32312824
Stat Med. 2017 Nov 30;36(27):4391-4400
pubmed: 28913837
BMC Geriatr. 2020 Aug 6;20(1):281
pubmed: 32762773
Dement Geriatr Cogn Disord. 2012;33(4):282-8
pubmed: 22759566
Med Care. 2009 Feb;47(2):191-8
pubmed: 19169120
Aust Health Rev. 2008 Aug;32(3):468-78
pubmed: 18666874
PLoS One. 2019 Mar 14;14(3):e0213787
pubmed: 30870521
J Aging Health. 2011 Feb;23(1):177-94
pubmed: 20881107
Am J Epidemiol. 2009 Jul 15;170(2):244-56
pubmed: 19494242
Med Care. 2008 Jul;46(7):647-53
pubmed: 18580382
Dement Geriatr Cogn Disord. 2008;26(1):65-78
pubmed: 18617737
Stroke. 2018 Nov;49(11):2659-2665
pubmed: 30355195
Arch Public Health. 2018 May 28;76:25
pubmed: 29881544
J Gerontol B Psychol Sci Soc Sci. 2012 Nov;67(6):765-74
pubmed: 22929396
Injury. 2020 Oct;51(10):2289-2294
pubmed: 32622625
PLoS One. 2018 Aug 15;13(8):e0202177
pubmed: 30110366
J Gerontol A Biol Sci Med Sci. 2000 May;55(5):M279-87
pubmed: 10819318
J Multidiscip Healthc. 2010 Mar 24;3:11-8
pubmed: 21197351
Eur J Public Health. 2016 Feb;26(1):182-7
pubmed: 25817209
JAMA Intern Med. 2019 May 1;179(5):668-675
pubmed: 30958504
J Gerontol B Psychol Sci Soc Sci. 2021 Jun 8;76(Suppl 1):S86-S96
pubmed: 34101810
Arch Public Health. 2013 Sep 18;71(1):24
pubmed: 24047278
Acta Orthop. 2010 Oct;81(5):548-55
pubmed: 20919809