Center for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
Center for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
J Am Med Dir Assoc. 2018 Feb;19(2):117-121.e3. doi: 10.1016/j.jamda.2017.08.004. Epub 2017 Sep 23.
To examine home care service-related and person-based factors associated with time to entry into permanent residential aged care.
Longitudinal cohort study using routinely collected client management data.
A large aged care service provider in New South Wales and the Australian Capital Territory, Australia.
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.
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.
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.
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.
探讨与居家护理服务相关的因素和以人为中心的因素与进入永久性居住养老院的时间的关系。
使用常规收集的客户管理数据进行的纵向队列研究。
澳大利亚新南威尔士州和澳大利亚首都直辖区的一家大型老年护理服务提供商。
共有 1116 名年龄在 60 岁及以上的人，他们在 2015 年 7 月 1 日至 2016 年 6 月 30 日期间开始接受更高层次需求的居家护理服务。
采用生存分析方法，研究与服务相关的因素和以人为中心的因素与首次居家护理服务与进入永久性居住养老院之间的时间关系。预测因子包括每周服务小时数、服务类型组合、人口统计学特征、需求、住院假和护理水平变化。聚类分析用于确定使用服务类型的模式。
截至 2016 年 12 月 31 日，使用居家护理服务的人中有 21.1%（n=235）已进入永久性居住养老院。在调整年龄和护理需求等重要因素后，每周每小时服务时间与进入养老院的风险降低 6%相关（风险比=0.94，95%置信区间 0.90-0.98）。主要使用社会支持服务的人、有指定照顾者的人以及出生在非主要英语国家的人也能更长时间地留在自己家中。
居家护理服务量越大，进入永久性居住养老院的时间就明显延迟。本研究提供了有关服务结果的急需证据，这些证据可用于为老年人的护理选择提供信息。
