基于社区的照护能力在塑造长期护理机构安置风险方面的作用。
The role of community-based care capacity in shaping risk of long-term care facility placement.
作者信息
Kuluski Kerry, Williams A Paul, Laporte Audrey, Berta Whitney
机构信息
Research Scientist, Bridgepoint Collaboratory for Research and Innovation, Bridgepoint Health, Assistant Professor, Institute of Health Policy, Management & Evaluation, Faculty of Medicine, University of Toronto, Toronto, ON.
出版信息
Healthc Policy. 2012 Aug;8(1):92-105.
OBJECTIVES
Across the developed world, wait lists for facility-based long-term care (LTC) beds continue to grow. Wait lists are primarily driven by the needs of aging populations (demand-side factors). Less attention has been given to system capacity to provide community alternatives to LTC (supply-side factors). We examine the role of both demand- and supply-side factors by comparing the characteristics of individuals who have been assessed and deemed eligible for LTC in urban and rural/underserviced parts of northwestern Ontario, Canada.
METHODS
Home care assessment data were analyzed for all individuals waiting for LTC in northwestern Ontario as of March 2008 (n=858). For the analysis, the sample was separated into urban and rural groups to account for geographical differences in wait list location. Characteristics between these two groups were compared.
RESULTS
Individuals on LTC wait lists in the rural areas were significantly less impaired in activities of daily living and cognition than their counterparts in the urban area. However, in both areas, impairments in lighter-care activities appeared to be a key wait list driver, and few people had an informal caregiver living in the home.
CONCLUSIONS
Our data suggest that LTC wait lists reflect, at least to some extent, insufficient community capacity, not just need for LTC.
目标
在整个发达国家，机构式长期护理（LTC）床位的等候名单持续增加。等候名单主要由老年人口的需求（需求方因素）驱动。而对于提供社区替代长期护理的系统能力（供应方因素）关注较少。我们通过比较加拿大安大略省西北部城市和农村/服务不足地区已接受评估并被认定符合长期护理资格的个人特征，来研究需求方和供应方因素的作用。
方法
对截至2008年3月在安大略省西北部等待长期护理的所有个人（n = 858）的家庭护理评估数据进行分析。为了进行分析，样本被分为城市组和农村组，以考虑等候名单地点的地理差异。比较这两组之间的特征。
结果
农村地区长期护理等候名单上的个人在日常生活活动和认知方面的受损程度明显低于城市地区的同龄人。然而，在这两个地区，轻度护理活动的受损似乎是等候名单的一个关键驱动因素，而且很少有人家中有非正式护理人员。
结论
我们的数据表明，长期护理等候名单至少在一定程度上反映了社区能力不足，而不仅仅是对长期护理的需求。
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