Kim Sujin, Yoo Jaeeon
Department of Health Care Policy Research, Korea Institute for Health and Social Affairs, Sejong-si, Republic of Korea.
Department of Social Welfare, Gachon University, Seongnam-si, Republic of Korea.
Alzheimers Dement. 2025 May;21(5):e70271. doi: 10.1002/alz.70271.
The role of community characteristics on supporting the community residence of older adults with dementia has received little attention. This study explores the association of community resources with extending older adults' stay in community settings and mitigating premature institutionalization and mortality.
Using data from 286,940 patients with dementia in South Korea, this study used Cox proportional hazard models to analyze the relationships among community management, institutionalization, mortality rates, and the availability of long-term care and medical resources at the municipal level, adjusting for individual factors.
Increased availability of home care nurses and physicians was significantly associated with enhanced community management, showing a noticeable decrease in mortality and institutionalization risk. Additionally, more home care social workers were associated with a reduced institutionalization risk, while an excess of medical and long-term care facilities was linked to a heightened institutionalization risk.
These findings underscore the importance of health-care resources aligning with the specific needs of patients with dementia.
Local health-care resources may affect dementia patients' community residence. Results reveal physicians and home case nurses lower institutionalization and death. Study findings indicate home care social workers also reduce institutionalization. But, more hospital beds and long-term care facilities increase institutionalization. This underscores the need for nuanced approaches to community-based care.
社区特征在支持老年痴呆症患者社区居住方面的作用很少受到关注。本研究探讨社区资源与延长老年人在社区环境中的停留时间、减轻过早入住机构照料和死亡率之间的关联。
本研究使用来自韩国286,940名痴呆症患者的数据，采用Cox比例风险模型分析社区管理、机构照料、死亡率以及市级长期护理和医疗资源的可获得性之间的关系，并对个体因素进行了调整。
家庭护理护士和医生数量的增加与社区管理的加强显著相关，死亡率和入住机构照料的风险显著降低。此外，更多的家庭护理社会工作者与入住机构照料风险的降低相关，而过多的医疗和长期护理设施则与入住机构照料风险的增加相关。
这些发现强调了医疗保健资源与痴呆症患者的特定需求相匹配的重要性。
当地医疗保健资源可能会影响痴呆症患者的社区居住情况。结果显示医生和家庭护理护士可降低入住机构照料率和死亡率。研究结果表明家庭护理社会工作者也可降低入住机构照料率。但是，更多的医院床位和长期护理设施会增加入住机构照料率。这凸显了对基于社区的护理采取细致入微方法的必要性。
