Change in care location of older adults who resided in group homes in Japan: An observational study using long‐term care insurance comprehensive database

Background Group homes have been introduced into Japanese public long‐term care insurance program to accommodate people with dementia in a homelike, small‐scale environments. The national dementia plan was launched in 2013 to promote provision of end‐of‐life care to people with dementia at group homes. However, discharge destinations from group homes have rarely been investigated. The present study examined the discharge destination of older adults between group homes and other types of homelike, small‐scale environments under the public long‐term care services. Method We used monthly data of January and July during 2013‐2016 from the long‐term care insurance comprehensive database. The 3,468 discharges from group home (n = 500), housing with care (n = 571), nursing home (n = 2097), or in‐home multiple service (n = 300) during 2013‐2016 were included in analysis. Result Of the 500 discharges from group homes, 173 (34.6%) were admitted to hospitals, 110 (22.0%) were admissions to facilities, and 178 (35.6%) were deceased. Controlling for individual characteristics and the use of specialized care, residents of group homes were more likely to be admitted to hospital rather than discharged by death, in comparison to those of housings with care (adjusted odds ratio [OR] = 0.35, 95% confidence interval [CI] = 0.25‐0.48) or nursing homes (adjusted OR = 0.25, 95%CI = 0.19‐0.32). Conclusion Group home residents were more likely to be hospitalised compared to residents of housings with care or nursing homes. Further dementia care strategies should be explored to reduce changes in location of care among people with dementia.