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.
ICES, Toronto, ON, Canada.
J Am Med Dir Assoc. 2021 Oct;22(10):2115-2120.e6. doi: 10.1016/j.jamda.2021.07.002. Epub 2021 Aug 2.
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.
我们研究了新诊断为痴呆症（未指定严重程度）且居住在提供痴呆症护理计划的辅助生活设施中的老年人与居住在没有此类计划的辅助生活设施中的老年人相比，其入住疗养院的比例是否较低。
基于人群的回顾性队列研究。
来自加拿大安大略省的新诊断为痴呆症且居住在辅助生活设施中的老年人的个人健康系统行政数据，2014 年至 2019 年（n=977）。
检查辅助生活设施中获得痴呆症护理计划的情况。使用多变量 Cox 比例风险回归和稳健标准误差，按辅助生活设施进行聚类，对从新诊断痴呆症到入住疗养院的时间进行建模。
在有痴呆症护理计划的辅助生活设施中，每 100 人年有 11.8 人入住疗养院，而在没有痴呆症护理计划的辅助生活设施中，每 100 人年有 20.5 人入住疗养院。在调整基线时的相关特征后，与居住在没有痴呆症护理计划的辅助生活设施的老年人相比，居住在有痴呆症护理计划的辅助生活设施的老年人入住疗养院的风险降低了 40%（风险比 0.60，95%置信区间 0.44，0.81），在整个随访期间的任何时候都如此。
居住在提供痴呆症护理计划的辅助生活设施中的老年人入住疗养院的比例明显较低。这些发现支持在辅助生活设施中扩大痴呆症护理计划。
