Transitions to Nursing Homes Among Residents of Assisted Living and Community-Dwelling Home Care Recipients
To examine transitions to a nursing home among residents of assisted living relative to community-dwelling home care recipients. Population-based retrospective cohort study emulating a target trial. Linked, individual-level health system data were obtained from older adults (≥65 years of age) who ma...
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| Veröffentlicht in: | Journal of the American Medical Directors Association 2024-12, p.105429, Article 105429 |
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| creator | Manis, Derek R. Kirkwood, David Fisher, Stacey Li, Wenshan Webber, Colleen Tanuseputro, Peter Stall, Nathan M. Watt, Jennifer A. Hsu, Amy T. Savage, Rachel D. Bronskill, Susan E. Costa, Andrew P. |
| description | To examine transitions to a nursing home among residents of assisted living relative to community-dwelling home care recipients.
Population-based retrospective cohort study emulating a target trial.
Linked, individual-level health system data were obtained from older adults (≥65 years of age) who made an incident application for a bed in a nursing home in Ontario, Canada, between April 1, 2014, and March 31, 2019, and were followed until December 31, 2019.
Residency in assisted living was compared with only community-dwelling home care. Any long-stay (≥90 days) and short-stay ( |
| doi_str_mv | 10.1016/j.jamda.2024.105429 |
| format | Article |
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Population-based retrospective cohort study emulating a target trial.
Linked, individual-level health system data were obtained from older adults (≥65 years of age) who made an incident application for a bed in a nursing home in Ontario, Canada, between April 1, 2014, and March 31, 2019, and were followed until December 31, 2019.
Residency in assisted living was compared with only community-dwelling home care. Any long-stay (≥90 days) and short-stay (<90 days) transitions to a nursing home were examined. Inverse probability weighted pooled logistic regression models were used to generate marginal cumulative incidence curves under each exposure status that were standardized by the covariates.
This study included 10,012 residents of assisted living (mean [SD] age 88.7 [6.26] years, 75% female) and 131,679 home care recipients (mean [SD] age 84.8 [7.43] years, 63% female) who applied for a bed in a nursing home (N = 141,691; 95,744.6 person-years). There were 6049 transitions among applicants from assisted living and 85,190 transitions among applicants who were home care recipients to a nursing home. The 5-year absolute risk reduction was 110 transitions to a nursing home per 1000 older adult applicants if all applicants resided in assisted living (95% CI, 71–148). Residency in assisted living resulted in a 12.7% relative decrease in the 5-year risk of any transition to a nursing home had all applicants resided in assisted living (95% CI, 8.3%–17.1%).
Residents of assisted living were less likely to transition to a nursing home, despite equivalent clinical complexity and health care needs. The integration of assisted living into the continuum of care from the community to institutionalized nursing homes would better inform health system capacity and planning.</description><identifier>ISSN: 1525-8610</identifier><identifier>ISSN: 1538-9375</identifier><identifier>EISSN: 1538-9375</identifier><identifier>DOI: 10.1016/j.jamda.2024.105429</identifier><identifier>PMID: 39709180</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Assisted living facilities ; home care ; long-term care ; nursing homes ; target trial emulation</subject><ispartof>Journal of the American Medical Directors Association, 2024-12, p.105429, Article 105429</ispartof><rights>2024</rights><rights>Copyright © 2024. Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0003-1396-3626</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39709180$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Manis, Derek R.</creatorcontrib><creatorcontrib>Kirkwood, David</creatorcontrib><creatorcontrib>Fisher, Stacey</creatorcontrib><creatorcontrib>Li, Wenshan</creatorcontrib><creatorcontrib>Webber, Colleen</creatorcontrib><creatorcontrib>Tanuseputro, Peter</creatorcontrib><creatorcontrib>Stall, Nathan M.</creatorcontrib><creatorcontrib>Watt, Jennifer A.</creatorcontrib><creatorcontrib>Hsu, Amy T.</creatorcontrib><creatorcontrib>Savage, Rachel D.</creatorcontrib><creatorcontrib>Bronskill, Susan E.</creatorcontrib><creatorcontrib>Costa, Andrew P.</creatorcontrib><title>Transitions to Nursing Homes Among Residents of Assisted Living and Community-Dwelling Home Care Recipients</title><title>Journal of the American Medical Directors Association</title><addtitle>J Am Med Dir Assoc</addtitle><description>To examine transitions to a nursing home among residents of assisted living relative to community-dwelling home care recipients.
Population-based retrospective cohort study emulating a target trial.
Linked, individual-level health system data were obtained from older adults (≥65 years of age) who made an incident application for a bed in a nursing home in Ontario, Canada, between April 1, 2014, and March 31, 2019, and were followed until December 31, 2019.
Residency in assisted living was compared with only community-dwelling home care. Any long-stay (≥90 days) and short-stay (<90 days) transitions to a nursing home were examined. Inverse probability weighted pooled logistic regression models were used to generate marginal cumulative incidence curves under each exposure status that were standardized by the covariates.
This study included 10,012 residents of assisted living (mean [SD] age 88.7 [6.26] years, 75% female) and 131,679 home care recipients (mean [SD] age 84.8 [7.43] years, 63% female) who applied for a bed in a nursing home (N = 141,691; 95,744.6 person-years). There were 6049 transitions among applicants from assisted living and 85,190 transitions among applicants who were home care recipients to a nursing home. The 5-year absolute risk reduction was 110 transitions to a nursing home per 1000 older adult applicants if all applicants resided in assisted living (95% CI, 71–148). Residency in assisted living resulted in a 12.7% relative decrease in the 5-year risk of any transition to a nursing home had all applicants resided in assisted living (95% CI, 8.3%–17.1%).
Residents of assisted living were less likely to transition to a nursing home, despite equivalent clinical complexity and health care needs. The integration of assisted living into the continuum of care from the community to institutionalized nursing homes would better inform health system capacity and planning.</description><subject>Assisted living facilities</subject><subject>home care</subject><subject>long-term care</subject><subject>nursing homes</subject><subject>target trial emulation</subject><issn>1525-8610</issn><issn>1538-9375</issn><issn>1538-9375</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNo1kU9PwzAMxSMEYjD4BEgoRy4dTtI2zYHDNP4MaQIJjXOUJh7KWJvRtEP79rQMTn6yfs-y_Qi5YjBhwPLb9WRtKmcmHHjad7KUqyNyxjJRJErI7HjQPEuKnMGInMe4BuDAVH5KRkJJUKyAM_K5bEwdfetDHWkb6EvXRF9_0HmoMNJpFXr9htE7rNtIw4pOY_SxRUcXfjeApnZ0Fqqqq327T-6_cbP599OZabB3W7_1g_2CnKzMJuLlXx2T98eH5WyeLF6fnmfTRYKMASRcQCFVYUpl85IrIw1KCyCYAZdlJWdohRCWlbzIi3JljXC5QkgFkyUYrsSY3Bzmbpvw1WFsdeWj7RczNYYuasFSqaRM06xHr__QrqzQ6W3jK9Ps9f-DeuDuAGC_8M5jo6Ptj7HofIO21S54zUAPgei1_g1ED4HoQyDiB_s-fgg</recordid><startdate>20241218</startdate><enddate>20241218</enddate><creator>Manis, Derek R.</creator><creator>Kirkwood, David</creator><creator>Fisher, Stacey</creator><creator>Li, Wenshan</creator><creator>Webber, Colleen</creator><creator>Tanuseputro, Peter</creator><creator>Stall, Nathan M.</creator><creator>Watt, Jennifer A.</creator><creator>Hsu, Amy T.</creator><creator>Savage, Rachel D.</creator><creator>Bronskill, Susan E.</creator><creator>Costa, Andrew P.</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1396-3626</orcidid></search><sort><creationdate>20241218</creationdate><title>Transitions to Nursing Homes Among Residents of Assisted Living and Community-Dwelling Home Care Recipients</title><author>Manis, Derek R. ; Kirkwood, David ; Fisher, Stacey ; Li, Wenshan ; Webber, Colleen ; Tanuseputro, Peter ; Stall, Nathan M. ; Watt, Jennifer A. ; Hsu, Amy T. ; Savage, Rachel D. ; Bronskill, Susan E. ; Costa, Andrew P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-e1100-2308798ab9c6b29a7ae7c0031a0d55b21ec333c1b2868bfca3d69e04317b0a293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Assisted living facilities</topic><topic>home care</topic><topic>long-term care</topic><topic>nursing homes</topic><topic>target trial emulation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Manis, Derek R.</creatorcontrib><creatorcontrib>Kirkwood, David</creatorcontrib><creatorcontrib>Fisher, Stacey</creatorcontrib><creatorcontrib>Li, Wenshan</creatorcontrib><creatorcontrib>Webber, Colleen</creatorcontrib><creatorcontrib>Tanuseputro, Peter</creatorcontrib><creatorcontrib>Stall, Nathan M.</creatorcontrib><creatorcontrib>Watt, Jennifer A.</creatorcontrib><creatorcontrib>Hsu, Amy T.</creatorcontrib><creatorcontrib>Savage, Rachel D.</creatorcontrib><creatorcontrib>Bronskill, Susan E.</creatorcontrib><creatorcontrib>Costa, Andrew P.</creatorcontrib><collection>PubMed</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>Manis, Derek R.</au><au>Kirkwood, David</au><au>Fisher, Stacey</au><au>Li, Wenshan</au><au>Webber, Colleen</au><au>Tanuseputro, Peter</au><au>Stall, Nathan M.</au><au>Watt, Jennifer A.</au><au>Hsu, Amy T.</au><au>Savage, Rachel D.</au><au>Bronskill, Susan E.</au><au>Costa, Andrew P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transitions to Nursing Homes Among Residents of Assisted Living and Community-Dwelling Home Care Recipients</atitle><jtitle>Journal of the American Medical Directors Association</jtitle><addtitle>J Am Med Dir Assoc</addtitle><date>2024-12-18</date><risdate>2024</risdate><spage>105429</spage><pages>105429-</pages><artnum>105429</artnum><issn>1525-8610</issn><issn>1538-9375</issn><eissn>1538-9375</eissn><abstract>To examine transitions to a nursing home among residents of assisted living relative to community-dwelling home care recipients.
Population-based retrospective cohort study emulating a target trial.
Linked, individual-level health system data were obtained from older adults (≥65 years of age) who made an incident application for a bed in a nursing home in Ontario, Canada, between April 1, 2014, and March 31, 2019, and were followed until December 31, 2019.
Residency in assisted living was compared with only community-dwelling home care. Any long-stay (≥90 days) and short-stay (<90 days) transitions to a nursing home were examined. Inverse probability weighted pooled logistic regression models were used to generate marginal cumulative incidence curves under each exposure status that were standardized by the covariates.
This study included 10,012 residents of assisted living (mean [SD] age 88.7 [6.26] years, 75% female) and 131,679 home care recipients (mean [SD] age 84.8 [7.43] years, 63% female) who applied for a bed in a nursing home (N = 141,691; 95,744.6 person-years). There were 6049 transitions among applicants from assisted living and 85,190 transitions among applicants who were home care recipients to a nursing home. The 5-year absolute risk reduction was 110 transitions to a nursing home per 1000 older adult applicants if all applicants resided in assisted living (95% CI, 71–148). Residency in assisted living resulted in a 12.7% relative decrease in the 5-year risk of any transition to a nursing home had all applicants resided in assisted living (95% CI, 8.3%–17.1%).
Residents of assisted living were less likely to transition to a nursing home, despite equivalent clinical complexity and health care needs. The integration of assisted living into the continuum of care from the community to institutionalized nursing homes would better inform health system capacity and planning.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>39709180</pmid><doi>10.1016/j.jamda.2024.105429</doi><orcidid>https://orcid.org/0000-0003-1396-3626</orcidid></addata></record> |
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| source | ScienceDirect Journals (5 years ago - present) |
| subjects | Assisted living facilities home care long-term care nursing homes target trial emulation |
| title | Transitions to Nursing Homes Among Residents of Assisted Living and Community-Dwelling Home Care Recipients |
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