Activities of Daily Living in Nursing Home and Home Care Settings: A Retrospective 1-Year Cohort Study
Abstract Objective Korea introduced universal long-term care insurance (LTCI) for physically dependent older adults in 2008. Older adults, their family members, and policy makers in Korea want to know patient outcomes in different care modalities because older adults who have a similar functional st...
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| Veröffentlicht in: | Journal of the American Medical Directors Association 2015-02, Vol.16 (2), p.114-119 |
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| creator | Lee, Tae Wha, RN, PhD Cho, Eunhee, RN, PhD Yim, Eun Shil, RN, PhD Lee, Hye Sun, MS Ko, Yu Kyung, RN, PhD Kim, Bok Nam, RN, PhD Kim, Sinhye, RN, MSN |
| description | Abstract Objective Korea introduced universal long-term care insurance (LTCI) for physically dependent older adults in 2008. Older adults, their family members, and policy makers in Korea want to know patient outcomes in different care modalities because older adults who have a similar functional status and LTC needs can choose either nursing home care or home care. The aim of this study was to compare activities of daily living (ADLs) in nursing home care and home care settings for physically dependent older adults in Korea. Design A retrospective 1-year cohort study using national LTCI data. Settings This study used the LTCI dataset from the National Health Insurance Service in Korea. Participants Participants were identified from among those in the LTCI dataset who enrolled from July 2008 to June 2010. We extracted a sample consisting of 22,557 older adults who consistently received either nursing home care (n = 11,678) or home care (n = 10,879) for 1 year. Measurements The outcome variable was change in ADLs after 1 year. Covariates were an older adult's home geographical region, LTC level, age, sex, primary caregiver, Medicaid beneficiary status, bedridden status, medical diagnosis, baseline ADLs, cognitive function, behavioral problems, nursing and special treatment, and rehabilitation needs. Multiple regression analysis of all participants unmatched and a paired t -test with a propensity-score-matched cohort were performed to explain the association of changes in ADLs with the types of LTC. Results Multiple regression analysis with all participants (n = 22,557) unmatched showed that compared with older adults who received home care, those who received nursing home care had deteriorated further in terms of ADLs after 1 year (β = 0.44108, P |
| doi_str_mv | 10.1016/j.jamda.2014.07.013 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1652419038</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1525861014004721</els_id><sourcerecordid>1652419038</sourcerecordid><originalsourceid>FETCH-LOGICAL-c480t-92e9a27571ee8cbbbf2145af6f790d7b727b00a28b5650faf5a11576746ab64d3</originalsourceid><addsrcrecordid>eNqFkU9v1DAQxSNERUvhEyAhH7kkzDhxnCCBtNoWWmkFEgsHTpaTjMEhf7a2U2m_PQ5bOHDh5Cf7vRnPb5LkBUKGgOXrPuv12OmMAxYZyAwwf5RcoMirtM6leLxqLtKqRDhPnnrfA0RrXT5JzrngRVGL6iIxmzbYexsseTYbdqXtcGS7eDN9Z3ZiHxfnV3kzj8T01J3EVjtiewohPvk3bMM-U3CzP9Baixim30g7tp1_zC6wfVi647PkzOjB0_OH8zL5-v76y_Ym3X36cLvd7NK2qCCkNadacykkElVt0zSGYyG0KY2soZON5LIB0LxqRCnAaCM0opClLErdlEWXXyavTnUPbr5byAc1Wt_SMOiJ5sUrLOPkWENeRWt-srbx696RUQdnR-2OCkGtgFWvfgNWK2AFUkXAMfXyocHSjNT9zfwhGg1vTwaKY95bcsq3lqaWOusiH9XN9j8N3v2Tbwc72VYPP-lIvp8XN0WCCpXnCtR-3fG6YiwACskx_wUSZ6DF</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1652419038</pqid></control><display><type>article</type><title>Activities of Daily Living in Nursing Home and Home Care Settings: A Retrospective 1-Year Cohort Study</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Lee, Tae Wha, RN, PhD ; Cho, Eunhee, RN, PhD ; Yim, Eun Shil, RN, PhD ; Lee, Hye Sun, MS ; Ko, Yu Kyung, RN, PhD ; Kim, Bok Nam, RN, PhD ; Kim, Sinhye, RN, MSN</creator><creatorcontrib>Lee, Tae Wha, RN, PhD ; Cho, Eunhee, RN, PhD ; Yim, Eun Shil, RN, PhD ; Lee, Hye Sun, MS ; Ko, Yu Kyung, RN, PhD ; Kim, Bok Nam, RN, PhD ; Kim, Sinhye, RN, MSN</creatorcontrib><description>Abstract Objective Korea introduced universal long-term care insurance (LTCI) for physically dependent older adults in 2008. Older adults, their family members, and policy makers in Korea want to know patient outcomes in different care modalities because older adults who have a similar functional status and LTC needs can choose either nursing home care or home care. The aim of this study was to compare activities of daily living (ADLs) in nursing home care and home care settings for physically dependent older adults in Korea. Design A retrospective 1-year cohort study using national LTCI data. Settings This study used the LTCI dataset from the National Health Insurance Service in Korea. Participants Participants were identified from among those in the LTCI dataset who enrolled from July 2008 to June 2010. We extracted a sample consisting of 22,557 older adults who consistently received either nursing home care (n = 11,678) or home care (n = 10,879) for 1 year. Measurements The outcome variable was change in ADLs after 1 year. Covariates were an older adult's home geographical region, LTC level, age, sex, primary caregiver, Medicaid beneficiary status, bedridden status, medical diagnosis, baseline ADLs, cognitive function, behavioral problems, nursing and special treatment, and rehabilitation needs. Multiple regression analysis of all participants unmatched and a paired t -test with a propensity-score-matched cohort were performed to explain the association of changes in ADLs with the types of LTC. Results Multiple regression analysis with all participants (n = 22,557) unmatched showed that compared with older adults who received home care, those who received nursing home care had deteriorated further in terms of ADLs after 1 year (β = 0.44108, P < .0001). After propensity-score matching, paired t -test analysis also found that the ADLs of older adults had deteriorated less in the home care group compared with the nursing home group after 1 year ( P < .0001). Conclusions The ADLs of older adults who received home care showed significantly less deterioration than those of the older adults in nursing home care after 1 year. The ADLs of older adults could differ according to the type of LTC they receive, and home care could result in better maintenance of ADLs than nursing home care.</description><identifier>ISSN: 1525-8610</identifier><identifier>EISSN: 1538-9375</identifier><identifier>DOI: 10.1016/j.jamda.2014.07.013</identifier><identifier>PMID: 25244958</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Activities of Daily Living ; Aged ; Aged, 80 and over ; Aging - physiology ; Cohort Studies ; Databases, Factual ; Disability Evaluation ; Female ; Geriatric Assessment ; home care services ; Home Care Services - organization & administration ; Humans ; Insurance, Long-Term Care - economics ; Internal Medicine ; Korea ; long-term care ; Long-Term Care - economics ; Long-Term Care - methods ; Male ; Medical Education ; Middle Aged ; nursing homes ; Nursing Homes - organization & administration ; older adults ; outcomes ; Quality of Life ; Republic of Korea ; Retrospective Studies ; Treatment Outcome</subject><ispartof>Journal of the American Medical Directors Association, 2015-02, Vol.16 (2), p.114-119</ispartof><rights>AMDA – The Society for Post-Acute and Long-Term Care Medicine</rights><rights>2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine</rights><rights>Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c480t-92e9a27571ee8cbbbf2145af6f790d7b727b00a28b5650faf5a11576746ab64d3</citedby><cites>FETCH-LOGICAL-c480t-92e9a27571ee8cbbbf2145af6f790d7b727b00a28b5650faf5a11576746ab64d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jamda.2014.07.013$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25244958$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Tae Wha, RN, PhD</creatorcontrib><creatorcontrib>Cho, Eunhee, RN, PhD</creatorcontrib><creatorcontrib>Yim, Eun Shil, RN, PhD</creatorcontrib><creatorcontrib>Lee, Hye Sun, MS</creatorcontrib><creatorcontrib>Ko, Yu Kyung, RN, PhD</creatorcontrib><creatorcontrib>Kim, Bok Nam, RN, PhD</creatorcontrib><creatorcontrib>Kim, Sinhye, RN, MSN</creatorcontrib><title>Activities of Daily Living in Nursing Home and Home Care Settings: A Retrospective 1-Year Cohort Study</title><title>Journal of the American Medical Directors Association</title><addtitle>J Am Med Dir Assoc</addtitle><description>Abstract Objective Korea introduced universal long-term care insurance (LTCI) for physically dependent older adults in 2008. Older adults, their family members, and policy makers in Korea want to know patient outcomes in different care modalities because older adults who have a similar functional status and LTC needs can choose either nursing home care or home care. The aim of this study was to compare activities of daily living (ADLs) in nursing home care and home care settings for physically dependent older adults in Korea. Design A retrospective 1-year cohort study using national LTCI data. Settings This study used the LTCI dataset from the National Health Insurance Service in Korea. Participants Participants were identified from among those in the LTCI dataset who enrolled from July 2008 to June 2010. We extracted a sample consisting of 22,557 older adults who consistently received either nursing home care (n = 11,678) or home care (n = 10,879) for 1 year. Measurements The outcome variable was change in ADLs after 1 year. Covariates were an older adult's home geographical region, LTC level, age, sex, primary caregiver, Medicaid beneficiary status, bedridden status, medical diagnosis, baseline ADLs, cognitive function, behavioral problems, nursing and special treatment, and rehabilitation needs. Multiple regression analysis of all participants unmatched and a paired t -test with a propensity-score-matched cohort were performed to explain the association of changes in ADLs with the types of LTC. Results Multiple regression analysis with all participants (n = 22,557) unmatched showed that compared with older adults who received home care, those who received nursing home care had deteriorated further in terms of ADLs after 1 year (β = 0.44108, P < .0001). After propensity-score matching, paired t -test analysis also found that the ADLs of older adults had deteriorated less in the home care group compared with the nursing home group after 1 year ( P < .0001). Conclusions The ADLs of older adults who received home care showed significantly less deterioration than those of the older adults in nursing home care after 1 year. The ADLs of older adults could differ according to the type of LTC they receive, and home care could result in better maintenance of ADLs than nursing home care.</description><subject>Activities of Daily Living</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aging - physiology</subject><subject>Cohort Studies</subject><subject>Databases, Factual</subject><subject>Disability Evaluation</subject><subject>Female</subject><subject>Geriatric Assessment</subject><subject>home care services</subject><subject>Home Care Services - organization & administration</subject><subject>Humans</subject><subject>Insurance, Long-Term Care - economics</subject><subject>Internal Medicine</subject><subject>Korea</subject><subject>long-term care</subject><subject>Long-Term Care - economics</subject><subject>Long-Term Care - methods</subject><subject>Male</subject><subject>Medical Education</subject><subject>Middle Aged</subject><subject>nursing homes</subject><subject>Nursing Homes - organization & administration</subject><subject>older adults</subject><subject>outcomes</subject><subject>Quality of Life</subject><subject>Republic of Korea</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>1525-8610</issn><issn>1538-9375</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU9v1DAQxSNERUvhEyAhH7kkzDhxnCCBtNoWWmkFEgsHTpaTjMEhf7a2U2m_PQ5bOHDh5Cf7vRnPb5LkBUKGgOXrPuv12OmMAxYZyAwwf5RcoMirtM6leLxqLtKqRDhPnnrfA0RrXT5JzrngRVGL6iIxmzbYexsseTYbdqXtcGS7eDN9Z3ZiHxfnV3kzj8T01J3EVjtiewohPvk3bMM-U3CzP9Baixim30g7tp1_zC6wfVi647PkzOjB0_OH8zL5-v76y_Ym3X36cLvd7NK2qCCkNadacykkElVt0zSGYyG0KY2soZON5LIB0LxqRCnAaCM0opClLErdlEWXXyavTnUPbr5byAc1Wt_SMOiJ5sUrLOPkWENeRWt-srbx696RUQdnR-2OCkGtgFWvfgNWK2AFUkXAMfXyocHSjNT9zfwhGg1vTwaKY95bcsq3lqaWOusiH9XN9j8N3v2Tbwc72VYPP-lIvp8XN0WCCpXnCtR-3fG6YiwACskx_wUSZ6DF</recordid><startdate>20150201</startdate><enddate>20150201</enddate><creator>Lee, Tae Wha, RN, PhD</creator><creator>Cho, Eunhee, RN, PhD</creator><creator>Yim, Eun Shil, RN, PhD</creator><creator>Lee, Hye Sun, MS</creator><creator>Ko, Yu Kyung, RN, PhD</creator><creator>Kim, Bok Nam, RN, PhD</creator><creator>Kim, Sinhye, RN, MSN</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150201</creationdate><title>Activities of Daily Living in Nursing Home and Home Care Settings: A Retrospective 1-Year Cohort Study</title><author>Lee, Tae Wha, RN, PhD ; Cho, Eunhee, RN, PhD ; Yim, Eun Shil, RN, PhD ; Lee, Hye Sun, MS ; Ko, Yu Kyung, RN, PhD ; Kim, Bok Nam, RN, PhD ; Kim, Sinhye, RN, MSN</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c480t-92e9a27571ee8cbbbf2145af6f790d7b727b00a28b5650faf5a11576746ab64d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Activities of Daily Living</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aging - physiology</topic><topic>Cohort Studies</topic><topic>Databases, Factual</topic><topic>Disability Evaluation</topic><topic>Female</topic><topic>Geriatric Assessment</topic><topic>home care services</topic><topic>Home Care Services - organization & administration</topic><topic>Humans</topic><topic>Insurance, Long-Term Care - economics</topic><topic>Internal Medicine</topic><topic>Korea</topic><topic>long-term care</topic><topic>Long-Term Care - economics</topic><topic>Long-Term Care - methods</topic><topic>Male</topic><topic>Medical Education</topic><topic>Middle Aged</topic><topic>nursing homes</topic><topic>Nursing Homes - organization & administration</topic><topic>older adults</topic><topic>outcomes</topic><topic>Quality of Life</topic><topic>Republic of Korea</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Tae Wha, RN, PhD</creatorcontrib><creatorcontrib>Cho, Eunhee, RN, PhD</creatorcontrib><creatorcontrib>Yim, Eun Shil, RN, PhD</creatorcontrib><creatorcontrib>Lee, Hye Sun, MS</creatorcontrib><creatorcontrib>Ko, Yu Kyung, RN, PhD</creatorcontrib><creatorcontrib>Kim, Bok Nam, RN, PhD</creatorcontrib><creatorcontrib>Kim, Sinhye, RN, MSN</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Medical Directors Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Tae Wha, RN, PhD</au><au>Cho, Eunhee, RN, PhD</au><au>Yim, Eun Shil, RN, PhD</au><au>Lee, Hye Sun, MS</au><au>Ko, Yu Kyung, RN, PhD</au><au>Kim, Bok Nam, RN, PhD</au><au>Kim, Sinhye, RN, MSN</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Activities of Daily Living in Nursing Home and Home Care Settings: A Retrospective 1-Year Cohort Study</atitle><jtitle>Journal of the American Medical Directors Association</jtitle><addtitle>J Am Med Dir Assoc</addtitle><date>2015-02-01</date><risdate>2015</risdate><volume>16</volume><issue>2</issue><spage>114</spage><epage>119</epage><pages>114-119</pages><issn>1525-8610</issn><eissn>1538-9375</eissn><abstract>Abstract Objective Korea introduced universal long-term care insurance (LTCI) for physically dependent older adults in 2008. Older adults, their family members, and policy makers in Korea want to know patient outcomes in different care modalities because older adults who have a similar functional status and LTC needs can choose either nursing home care or home care. The aim of this study was to compare activities of daily living (ADLs) in nursing home care and home care settings for physically dependent older adults in Korea. Design A retrospective 1-year cohort study using national LTCI data. Settings This study used the LTCI dataset from the National Health Insurance Service in Korea. Participants Participants were identified from among those in the LTCI dataset who enrolled from July 2008 to June 2010. We extracted a sample consisting of 22,557 older adults who consistently received either nursing home care (n = 11,678) or home care (n = 10,879) for 1 year. Measurements The outcome variable was change in ADLs after 1 year. Covariates were an older adult's home geographical region, LTC level, age, sex, primary caregiver, Medicaid beneficiary status, bedridden status, medical diagnosis, baseline ADLs, cognitive function, behavioral problems, nursing and special treatment, and rehabilitation needs. Multiple regression analysis of all participants unmatched and a paired t -test with a propensity-score-matched cohort were performed to explain the association of changes in ADLs with the types of LTC. Results Multiple regression analysis with all participants (n = 22,557) unmatched showed that compared with older adults who received home care, those who received nursing home care had deteriorated further in terms of ADLs after 1 year (β = 0.44108, P < .0001). After propensity-score matching, paired t -test analysis also found that the ADLs of older adults had deteriorated less in the home care group compared with the nursing home group after 1 year ( P < .0001). Conclusions The ADLs of older adults who received home care showed significantly less deterioration than those of the older adults in nursing home care after 1 year. The ADLs of older adults could differ according to the type of LTC they receive, and home care could result in better maintenance of ADLs than nursing home care.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25244958</pmid><doi>10.1016/j.jamda.2014.07.013</doi><tpages>6</tpages></addata></record> |
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| subjects | Activities of Daily Living Aged Aged, 80 and over Aging - physiology Cohort Studies Databases, Factual Disability Evaluation Female Geriatric Assessment home care services Home Care Services - organization & administration Humans Insurance, Long-Term Care - economics Internal Medicine Korea long-term care Long-Term Care - economics Long-Term Care - methods Male Medical Education Middle Aged nursing homes Nursing Homes - organization & administration older adults outcomes Quality of Life Republic of Korea Retrospective Studies Treatment Outcome |
| title | Activities of Daily Living in Nursing Home and Home Care Settings: A Retrospective 1-Year Cohort Study |
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